Video-assisted thoracic surgery resection for pediatric mediastinal neurogenic tumors

Pediatric Thoracic Surgery Unit/Pediatric Surgery Service, Hospital de Clínicas de Porto Alegre, Porto Alegre RS 90035-903, Brazil.
Journal of Pediatric Surgery (Impact Factor: 1.39). 07/2012; 47(7):1349-53. DOI: 10.1016/j.jpedsurg.2012.01.067
Source: PubMed


Video-assisted thoracoscopic surgery (VATS) resection of mediastinal neurogenic tumors is still controversial in children. The aim of this study was to review the cases of VATS resection of such tumors in children from 3 institutions located in different countries.
This retrospective study included 17 children treated between July 1995 and February 2011. Medical charts were reviewed for collection of data on age, sex, histologic type of tumor, clinical manifestations, age and weight at surgery, tumor size, duration of thoracic drainage, surgical complications, tumor recurrence, and mortality.
Thirteen (76.5%) males and 4 (23.5%) females were studied. Median age was 16 months (range, 10.6-60 months), and median weight was 11.9 kg (range, 9.3-27.4 kg). Ten children had neuroblastoma (58.8%), 4 had ganglioneuroma (23.5%), and 3 had ganglioneuroblastoma (17.7%). The median duration of the operation was 90 minutes (range, 45-180 minutes), with complete thoracoscopic resection in all cases. Two children (11.8%) developed Horner syndrome postoperatively. No deaths were reported, and no recurrence was noted during a median follow-up period of 16 months (range, 8.9-28.6 months).
Video-assisted thoracoscopic surgery resection of mediastinal neurogenic tumors in children produced good results, with no recurrence and minimal postoperative complications. The major advantages of this approach are the avoidance of thoracotomy complications and the enhanced surgical accuracy provided by improved visualization.

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    • "MIS has become a commonly used approach in these cases for biopsy and resection. Several studies could demonstrate equally good oncological and surgical outcomes in respective patients compared to open surgery (18–21). Surgical and clinical outcomes seem superior in comparison to the open approach because patients are spared thoracotomies or sternotomies. "
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    ABSTRACT: During recent years, minimally invasive surgery (MIS) has become the standard approach for various operations in infants and children. This also holds true for surgery in children with solid tumors. Meanwhile, more and more oncological biopsies and resections are being performed laparoscopically or thoracoscopically. Despite its increasing role in pediatric tumor surgery, the different national and international multicenter trial groups have not yet implemented MIS within guidelines and recommendations in most of the current treatment protocols. An increasing number of reports describe a potential role of MIS in the different entities of pediatric surgical oncology. Over the time, there has been a diverse development of this approach with regard to the different neoplasms. The aim of this article is to give an overview and to describe the current state of the art of MIS in pediatric solid tumors.
    Full-text · Article · Jun 2014 · Frontiers in Pediatrics
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    • "It provides a better visualization of the tumor and its anatomic connections of mediastinal structures. VATS thymectomy and removal of neurogenic mediastinal tumors in children produced good results with minimal complications [13, 14]. Other advanced intrathoracic procedures such as repair of congenital diaphragmatic hernia and eventration, primary repair of esophageal atresia and tracheoesophageal fistula (TEF), and closure of patent ductus arteriosus ligation have been described in children. "
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    ABSTRACT: Minimally invasive technology or laparoscopic surgery underwent a major breakthrough over the past two decades. The first experience of thoracoscopy in children was reported around 1980 for diagnosis of intrathoracic pathology and neoplasia. Up until the middle of the 1990s, the surgical community in Taiwan was still not well prepared to accept the coming era of minimally invasive surgery. In the beginning, laparoscopy was performed in only a few specialties and only relatively short or simple surgeries were considered. But now, the Taiwan's experiences over the several different clinical scenarios were dramatically increased. Therefore, we elaborated on the experience about pectus excavatum: Nuss procedure, primary spontaneous hemopneumothorax, thoracoscopic thymectomy, and empyema in Taiwan.
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    ABSTRACT: Cold abscess neck is a common disease entity in Indian subcontinent, however its association with Horner’s syndrome is rare. Our patient was a girl presenting with neck mass with loss of sweating on same side of face. Her investigations revealed a multiloculated minimally enhancing lesion arising from posterior cervical space and extending into mediastinum, provisional diagnosis of tubercular cold abscess was made and Anti Tubercular Therapy (ATT) was started. She did not show much improvement, so she was operated via left lateral thoracotomy and the mass was excised, post operatively she recovered well. There are several causes of Horner’s syndrome but its association with tubercular cold abscess neck is unique and very few case reports exist in English literature.
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