Gülşen EKİNGEN, Selami SÖZÜBİR, Haluk GÜVENÇ, Ufuk ŞENEL

Çocuklarda video destekli torakoskopik cerrahi deneyimimiz

Amaç: Günümüzde video endoskopi alanındaki teknolojik gelişmeler torakoskopik cerrahinin çocuk yaş grubunda güvenle uygulanmasına imkan sağlamıştır. Bu yazıda, kliniğimizde torakoskopik cerrahi uygulanan olguları ve sonuçlarını değerlendirmeyi amaçladık. Materyal ve Metod: 2001-2003 yılları arasında yaş ortalaması 5.6 yıl olan 19 olguya video destekli torakoskopik cerrahi (VATS) girişim uygulandı. Olgularda, ampiyem, akciğer apsesi, kist hidatik, pnömotosel, diyafram eventrasyonu, mediastinal kitle, göğüs duvarı arteriyovenöz malformasyon gibi toraks patolojileri mevcuttu. Tüm olgularda ameliyat öncesi radyolojik inceleme yapılarak lezyonun yeri tespit edildikten sonra genel anestezi altında VATS uygulandı.Bulgular: Ortalama ameliyat süresi 95 dk (75-180), tüp drenaj süresi 4 (1-8) gün ve hastanede kalış süresi 7.2 (3-11) gündü. Olguların ikisinde açık cerrahiye geçildi ve bir olgu reopere edildi. Olguların hiçbiri kaybedilmedi.Sonuç: Video destekli torakoskopik cerrahinin çocuk yaş grubu cerrahi toraks patolojilerinde güvenilir bir tedavi seçeneği olduğunu düşünmekteyiz.

Experience with video assisted thoracoscopic surgery in children

Background: Nowadays, advances in video-endoscopic technology have allowed for application of thoracoscopic surgery in pediatric population. The aim of study was to evaluate the video-assisted thoracoscopic surgery in children with various chest diseases Methods: Between 2001 and 2003, video- assisted thoracoscopic surgery was performed in 19 patients with a mean age of 5. 6 years. The diseases included empyema, lung abscess, pneumothocell, diaphragm eventration, mediastinal mass, chest wall arterio-venous malformation. In all cases, localization of lesions were determined by radiological examination before operation and the surgery was done under bilateral lung ventilation.Results: The mean operative time was 95 minutes (75-180). The mean duration of chest tube drainage was 4 days (1-8) and hospital stay was 7.2 days after surgery (3-11). Conversion to open surgery was necessary in two cases. One patient was reoperated. There is no death.Conclusion: We consider that video-assisted thoracoscopic surgery can be preferred safely for management of chest disease in children.

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