1
|
Dagorno C, Montalva L, Ali L, Brustia R, Paye-Jaquen A, Pio L, Bonnard A. Enhancing recovery after minimally invasive surgery in children: A systematic review of the literature and meta-analysis. J Pediatr Surg 2021; 56:2157-2164. [PMID: 34030881 DOI: 10.1016/j.jpedsurg.2021.04.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 03/23/2021] [Accepted: 04/05/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Enhanced recovery after surgery (ERAS) has been widely implemented after minimally invasive surgeries (MIS) in adults. The aim of this study was to evaluate the current evidence available on ERAS after MIS in children. METHODS Using a defined search strategy (PubMed, Cochrane, Scopus), we performed a systematic review of the literature, searching for studies reporting on ERAS after MIS (thoracoscopy, laparoscopy, retroperitoneoscopy) in children (1975-2019). This study was registered with PROSPERO-international prospective register of systematic reviews. A meta-analysis was conducted using comparative studies for length of stay (LOS), complication rates, and readmission rates. RESULTS Of 180 abstracts screened, 20 full-text articles were analyzed, and 9 were included in our systematic review (1 randomized controlled trial, 3 prospective, and 5 retrospective studies), involving a total number of 531 patients. ERAS has been applied to laparoscopy for digestive (n = 7 studies) or urologic surgeries (n = 1), as well as thoracoscopy (n = 1). Mean LOS was decreased in ERAS children compared to controls (6 studies, -1.12 days, 95%IC: -1.5 to -0.82, p < 0.00001). There was no difference in complication rates between ERAS children and control children (5 studies, 13% vs 14%, OR = 0.84, 95%CI: 0.49-1.44, p = 0.52). The 30-day readmission rate was decreased in ERAS children compared to controls (6 studies, 4% vs 10%, OR = 0.34, 95%CI: 0.18-0.66, p = 0.001). CONCLUSIONS Although the evidence regarding ERAS in MIS is scarce, these protocols seem safe and effective, by decreasing LOS and 30-day readmission rate, without increasing post-operative complication rates.
Collapse
Affiliation(s)
- Claire Dagorno
- Department of Pediatric Surgery and Urology, Robert-Debré University Hospital, APHP, 48 boulevard Sérurier, 75019 Paris, France.
| | - Louise Montalva
- Department of Pediatric Surgery and Urology, Robert-Debré University Hospital, APHP, 48 boulevard Sérurier, 75019 Paris, France
| | - Liza Ali
- Department of Pediatric Surgery and Urology, Robert-Debré University Hospital, APHP, 48 boulevard Sérurier, 75019 Paris, France
| | - Raffaele Brustia
- Paris University, Paris, France; Department of Colorectal and Hepatobiliary Surgery, Henri-Mondor University Hospital, Creteil, France
| | - Annabel Paye-Jaquen
- Department of Pediatric Surgery and Urology, Robert-Debré University Hospital, APHP, 48 boulevard Sérurier, 75019 Paris, France; Paris University, Paris, France
| | - Luca Pio
- Department of Pediatric Surgery and Urology, Robert-Debré University Hospital, APHP, 48 boulevard Sérurier, 75019 Paris, France; Paris University, Paris, France
| | - Arnaud Bonnard
- Department of Pediatric Surgery and Urology, Robert-Debré University Hospital, APHP, 48 boulevard Sérurier, 75019 Paris, France; Paris University, Paris, France; UFR de Médecine, Université Paris Diderot-Sorbonne Paris Cité, Paris, France
| |
Collapse
|
2
|
Video-assisted thoracoscopic surgery is safe and reliable for large and invasive primary mediastinal tumors. Wideochir Inne Tech Maloinwazyjne 2020; 16:163-168. [PMID: 33786130 PMCID: PMC7991948 DOI: 10.5114/wiitm.2020.94528] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 03/22/2020] [Indexed: 11/17/2022] Open
Abstract
Introduction Video-assisted thoracoscopic surgery (VATS) was not considered for the treatment of primary mediastinal tumors of large sizes or with local invasion. Aim To investigate the clinical outcomes of VATS for large and invasive mediastinal tumors. Material and methods One hundred and thirteen patients with primary mediastinal tumors were treated by VATS. Twenty-nine patients had bulky tumors (diameter > 6 cm) and 5 patients had invasive tumors. Clinical data were documented and compared. Results No patients suffered from any complications after VATS. No relapse or metastasis occurred in the patients with bulky tumors, while 1 patient with invasive thymoma suffered a relapse after VATS. The 2-year disease-free survival and overall survival in patients with bulky tumors were 100% and 100%, while those in patients with invasive tumors were 75% and 100%. There were no differences in hospital stay after VATS between the patients with bulky tumors and smaller tumors, nor between the patients with invasive tumors and non-invasive tumors. Patients with bulky tumors lost more blood than those with smaller tumors, while more blood loss occurred in patients with invasive tumors than non-invasive tumors. Longer operative time was needed for patients with bulky tumors and invasive tumors. Mediastinal tumors with large size or invasion should not be contraindicated for VATS. The prognosis of such patients treated with VATS was comparable to that of traditional open surgery. Conclusions VATS is a safe and effective procedure for large and invasive mediastinal tumors.
Collapse
|
3
|
Thoracoscopy vs. thoracotomy for the repair of esophageal atresia and tracheoesophageal fistula: a systematic review and meta-analysis. Pediatr Surg Int 2019; 35:1167-1184. [PMID: 31359222 DOI: 10.1007/s00383-019-04527-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/19/2019] [Indexed: 12/14/2022]
Abstract
Esophageal atresia (EA) and tracheoesophageal fistula (TEF) require emergency surgery in the neonatal period to prevent aspiration and respiratory compromise. Surgery was once exclusively performed via thoracotomy; however, there has been a push to correct this anomaly thoracoscopically. In this study, we compare intra- and post-operative outcomes of both techniques. A systematic review and meta-analyses was performed. A search strategy was developed in consultation with a librarian which was executed in CENTRAL, MEDLINE, and EMBASE from inception until January 2017. Two independent researchers screened eligible articles at title and abstract level. Full texts of potentially relevant articles were then screened again. Relevant data were extracted and analyzed. 48 articles were included. A meta-analysis found no statistically significant difference between thoracoscopy and thoracotomy in our primary outcome of total complication rate (OR 0.98, [0.29, 3.24], p = 0.97). Likewise, there were no statistically significant differences in anastomotic leak rates (OR 1.55, [0.72, 3.34], p = 0.26), formation of esophageal strictures following anastomoses that required one or more dilations (OR 1.92, [0.93, 3.98], p = 0.08), need for fundoplication following EA repair (OR 1.22, [0.39, 3.75], p = 0.73)-with the exception of operative time (MD 30.68, [4.35, 57.01], p = 0.02). Considering results from thoracoscopy alone, overall mortality in patients was low at 3.2% and in most cases was due to an associated anomaly rather than EA repair. Repair of EA/TEF is safe, with no statistically significant differences in morbidity when compared with an open approach.Level of evidence 3a systematic review of case-control studies.
Collapse
|
4
|
Feola GP, Hogan MJ, Baskin KM, Cahill AM, Connolly BL, Crowley JJ, Charles JA, Heran MK, Marshalleck FE, Sierre S, Towbin RB, Walker TG, Silberzweig JE, Censullo M, Dariushnia SR, Gemmete JJ, Weinstein JL, Nikolic B. Quality Improvement Standards for the Treatment of Pediatric Empyema. J Vasc Interv Radiol 2018; 29:1415-1422. [DOI: 10.1016/j.jvir.2018.04.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 04/24/2018] [Accepted: 04/26/2018] [Indexed: 01/14/2023] Open
|
5
|
Horkan DB, Tashiro J, Wagenaar AE, Perez EA. Laparoscopy in Pediatric Trauma: The Advancement of Minimally Invasive Techniques for Abdominal Trauma. CURRENT SURGERY REPORTS 2016. [DOI: 10.1007/s40137-016-0132-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
6
|
Velhote MCP, Tannuri U, Andrade WDC, Maksoud Filho JG, Apezzato MLDP, Tannuri ACA. [Videosurgery in infancy and childhood: state of the art. Experience with 1408 procedures in the Instituto da Criança "Pedro de Alcântara"]. Rev Col Bras Cir 2012; 39:425-35. [PMID: 23174797 DOI: 10.1590/s0100-69912012000500016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2012] [Accepted: 07/27/2012] [Indexed: 11/22/2022] Open
Abstract
The videosurgery in Pediatric Surgery has a large field of applications unfortunately still underexplored. There are few services that routinely use this techinic , and Brazilian articles published are scarce. The Institute of Children's Hospital of the Faculty of Medicine, University of São Paulo, has been using for fifteen years the videosurgery which is now the first choice of treatment, among other diseases as gastroesophageal reflux, the cholecystolithiasis, the nonpalpable undescended testicles and megaesophagus. In this article we report our experience in laparoscopic pediatric surgery, acquired with 1408 surgical procedures, to present this useful method, and beneficial to a large number of situations and still underused in Pediatric Surgery.
Collapse
|
7
|
Islam S, Calkins CM, Goldin AB, Chen C, Downard CD, Huang EY, Cassidy L, Saito J, Blakely ML, Rangel SJ, Arca MJ, Abdullah F, St Peter SD. The diagnosis and management of empyema in children: a comprehensive review from the APSA Outcomes and Clinical Trials Committee. J Pediatr Surg 2012; 47:2101-10. [PMID: 23164006 DOI: 10.1016/j.jpedsurg.2012.07.047] [Citation(s) in RCA: 125] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2012] [Revised: 07/23/2012] [Accepted: 07/25/2012] [Indexed: 11/16/2022]
Abstract
The aim of this study is to review the current evidence on the diagnosis and management of empyema. The American Pediatric Surgical Association Outcomes and Clinical Trials Committee compiled 8 questions to address. A comprehensive review was performed on each topic. Topics included the distinction between parapneumonic effusion and empyema, the optimal imaging modality in evaluating pleural space disease, when and how pleural fluid should be managed, the first treatment option and optimal timing in the management of empyema, the optimal chemical debridement agent for empyema, therapeutic options if chemical debridement fails, therapy for parenchymal abscess or necrotizing pneumonia and duration of antibiotic therapy after an intervention. The evidence was graded for each topic to provide grade of recommendation where appropriate.
Collapse
Affiliation(s)
- Saleem Islam
- University of Florida College of Medicine, Gainesville, FL, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Rothenberg SS. The Role of Thoracoscopic Decortication in the Treatment of Childhood Empyema. PEDIATRIC ALLERGY IMMUNOLOGY AND PULMONOLOGY 2012. [DOI: 10.1089/ped.2012.0156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Steven S. Rothenberg
- Columbia University College of Physicians and Surgeons, New York, New York
- The Rocky Mountain Hospital for Children, Denver, Colorado
| |
Collapse
|
9
|
Ceelie I, van Dijk M, Bax N, de Wildt S, Tibboell D. Does minimal access major surgery in the newborn hurt less? An evaluation of cumulative opioid doses. Eur J Pain 2012; 15:615-20. [DOI: 10.1016/j.ejpain.2010.11.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2010] [Revised: 11/07/2010] [Accepted: 11/24/2010] [Indexed: 10/18/2022]
|
10
|
Seguier-Lipszyc E, Elizur A, Klin B, Vaiman M, Lotan G. Management of primary spontaneous pneumothorax in children. Clin Pediatr (Phila) 2011; 50:797-802. [PMID: 21482575 DOI: 10.1177/0009922811404699] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To examine the role of CT scans and early surgical intervention in the management of pediatric patients with primary spontaneous pneumothorax (PSP). METHODS Retrospective cohort study. RESULTS The authors identified 46 cases with 70 episodes of pneumothorax. The recurrence rate among conservatively treated patients was 50% both after the first and the subsequent episode. Recurrence rate in cases with and without blebs on CT was comparable. Initial episodes were treated with supplemental oxygen (n = 18) and chest tube drainage (n = 18), and 10 patients underwent video-assisted thoracoscopic surgery (VATS). The recurrence rate was significantly lower following surgical intervention compared with other therapy, and morbidity was comparable with that in patients who needed chest tube drainage. CONCLUSIONS Recurrence after the first episode of PSP in children is frequent and is difficult to predict by CT findings. VATS is safe and effective in preventing recurrences. Surgical intervention may be an attractive alternative in patients who require chest tube drainage for the first episode of PSP.
Collapse
|
11
|
Kumar K, Basker S, Jeslin L, Karthikeyan C, Matthias A. Anaesthesia for pediatric video assisted thoracoscopic surgery. J Anaesthesiol Clin Pharmacol 2011; 27:12-6. [PMID: 21804698 PMCID: PMC3146131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Kamal Kumar
- Assistant Professor, Department of Anaesthesia and Critical Care, Christian Medical College & Hospital, Vellore, India.
| | - Sujatha Basker
- Assistant Professor, Department of Anaesthesia and Critical Care, Christian Medical College & Hospital, Vellore, India.
| | - L. Jeslin
- Assistant Professor, Department of Anaesthesia and Critical Care, Christian Medical College & Hospital, Vellore, India.
| | - C. Karthikeyan
- Assistant Professor, Department of Anaesthesia and Critical Care, Christian Medical College & Hospital, Vellore, India.
| | - Archana Matthias
- Assistant Professor, Department of Anaesthesia and Critical Care, Christian Medical College & Hospital, Vellore, India.
| |
Collapse
|
12
|
Abstract
Minimally invasive surgery (MIS) has significantly improved the field of surgery, with benefits including shorter operating time, improved recovery time, minimizing stress and pain due to smaller incisions, and even improving mortality. MIS procedures, including their indications, impact, limitations, and possible future evolution in neonates and infants, are discussed in this article.
Collapse
Affiliation(s)
- Tiffany Lin
- DeBakey Department of Pediatric Surgery, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
| | | |
Collapse
|
13
|
Lecomte B, Hadden H, Coste K, Gallot D, Laurichesse H, Lemery D, Scheye T, Dechelotte P, Labbé A. Hyperechoic congenital lung lesions in a non-selected population: from prenatal detection till perinatal management. Prenat Diagn 2009; 29:1222-30. [DOI: 10.1002/pd.2407] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
14
|
St. Peter SD, Tsao K, Harrison C, Jackson MA, Spilde TL, Keckler SJ, Sharp SW, Andrews WS, Holcomb GW, Ostlie DJ, Holcomb GW, Ostlie DJ. Thoracoscopic decortication vs tube thoracostomy with fibrinolysis for empyema in children: a prospective, randomized trial. J Pediatr Surg 2009; 44:106-11; discussion 111. [PMID: 19159726 PMCID: PMC3086274 DOI: 10.1016/j.jpedsurg.2008.10.018] [Citation(s) in RCA: 193] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2008] [Accepted: 10/07/2008] [Indexed: 01/24/2023]
Abstract
PURPOSE Management of empyema has been debated in the literature for decades. Although both primary video-assisted thoracoscopic surgery (VATS) and tube thoracostomy with pleural instillation of fibrinolytics have been shown to result in early resolution when compared to tube thoracostomy alone, there is a lack of comparative data between these modes of management. Therefore, we conducted a prospective, randomized trial comparing VATS to fibrinolytic therapy in children with empyema. METHODS After Institutional Review Board approval, children defined as having empyema by either loculation on imaging or more than 10,000 white blood cells/microL were treated with VATS or fibrinolysis. Based on our retrospective data using length of postoperative hospitalization as the primary end point, a sample size of 36 patients was calculated for an alpha of .5 and a power of 0.8. Fibrinolysis consisted of inserting a 12F chest tube followed by infusion of 4 mg tissue plasminogen activator mixed with 40 mL of normal saline at the time of tube placement followed by 2 subsequent doses 24 hours apart. RESULTS At diagnosis, there were no differences between groups in age, weight, degree of oxygen support, white blood cell count, or days of symptoms. The outcome data showed no difference in days of hospitalization after intervention, days of oxygen requirement, days until afebrile, or analgesic requirements. Video-assisted thoracoscopic surgery was associated with significantly higher charges. Three patients (16.6%) in the fibrinolysis group subsequently required VATS for definitive therapy. Two patients in the VATS group required ventilator support after therapy, one of whom required temporary dialysis. No patient in the fibrinolysis group clinically worsened after initiation of therapy. CONCLUSIONS There are no therapeutic or recovery advantages between VATS and fibrinolysis for the treatment of empyema; however, VATS resulted in significantly greater charges. Fibrinolysis may pose less risk of acute clinical deterioration and should be the first-line therapy for children with empyema.
Collapse
Affiliation(s)
- Shawn D. St. Peter
- Center for Prospective Clinical Trials, Department of Pediatric Surgery, Children’s Mercy Hospital, Kansas City, MO 64108, USA
,Corresponding author. Tel.: +1 816 983 6479; fax: +1 816 983 6885. .
| | - Kuojen Tsao
- Center for Prospective Clinical Trials, Department of Pediatric Surgery, Children’s Mercy Hospital, Kansas City, MO 64108, USA
| | - Christopher Harrison
- Department of Infectious Disease, Children’s Mercy Hospital, Kansas City, MO 64108, USA
| | - Mary Ann Jackson
- Center for Prospective Clinical Trials, Department of Pediatric Surgery, Children’s Mercy Hospital, Kansas City, MO 64108, USA
| | - Troy L. Spilde
- Center for Prospective Clinical Trials, Department of Pediatric Surgery, Children’s Mercy Hospital, Kansas City, MO 64108, USA
| | - Scott J. Keckler
- Center for Prospective Clinical Trials, Department of Pediatric Surgery, Children’s Mercy Hospital, Kansas City, MO 64108, USA
| | - Susan W. Sharp
- Center for Prospective Clinical Trials, Department of Pediatric Surgery, Children’s Mercy Hospital, Kansas City, MO 64108, USA
| | - Walter S. Andrews
- Center for Prospective Clinical Trials, Department of Pediatric Surgery, Children’s Mercy Hospital, Kansas City, MO 64108, USA
| | - George W. Holcomb
- Center for Prospective Clinical Trials, Department of Pediatric Surgery, Children’s Mercy Hospital, Kansas City, MO 64108, USA
| | - Daniel J. Ostlie
- Center for Prospective Clinical Trials, Department of Pediatric Surgery, Children’s Mercy Hospital, Kansas City, MO 64108, USA
| | | | | |
Collapse
|
15
|
Tan TW, Kim DS, Wallach MT, Mangray S, Luks FI. Thoracoscopic resection of a giant thymolipoma in a 4-year-old girl. J Laparoendosc Adv Surg Tech A 2008; 18:903-5. [PMID: 18922057 DOI: 10.1089/lap.2008.0006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Thymolipoma is a very rare, benign mediastinal tumor. In this paper, we report on the thoracoscopic resection of such a lesion in a 4-year-old girl.
Collapse
Affiliation(s)
- Tze Woei Tan
- Division of Pediatric Surgery, Hasbro Children's Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island 02905, USA
| | | | | | | | | |
Collapse
|