Thoracoscopic resection of neurogenic tumors in children

Thoracic neuroblastoma: a retrospective review of our institutional experience with comparison of the thoracoscopic and open approaches to resection

“…This risk would presumably be avoided with the thoracoscopic approach to resection. Advocates of the VATS approach to aid in visualization and dissection as well as avoidance of postthoracotomy sequelae suggest that VATS be considered for thoracic lesions based upon certain criteria such as tumor size, location, N-myc amplification, and resectability [4]. In this multicenter study, they reported complete thoracoscopic resection (n = 21), no recurrences, and no conversion to open thoracotomy.…”

“…After the year 2000, most thoracic neuroblastomas at our institution (11/14) have been resected using a thoracoscopic approach. The minimally invasive approach has several well-accepted advantages including enhanced visualization, shorter length of stay, and less postoperative pain [4,6,7]. We sought to confirm that in the case of thoracic neuroblastoma, a thoracoscopic approach would indeed provide patients with these advantages without negatively affecting outcome.…”

“…Because the visualization afforded by thoracoscopy is superior, tumors entering spinal foramina can be easily identified, and an adequate, safe, controlled resection can be performed as indicated. LaCreuse et al [4] has suggested that tumors extending into the paraspinal space may not be amenable or reasonable to approach minimally invasively. We would agree with this statement but had no such tumors in our thoracoscopic group.…”

“…Despite reports that suggest complete resection is not always necessary for cure for thoracic neuroblastoma [3], it has also been demonstrated that the thoracoscopic approach to resection can offer equivalent results with resection compared to open techniques. Several institutions have reported the regular application of the minimally invasive approach for thoracic neuroblastomas with good results [4][5][6]. Here, we review our own institutional experience with thoracic neuroblastoma for an 18-year period (1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007) comparing the open and minimally invasive approaches.…”

Chylothorax in Infants and Children

“…55,56,68 Chylothorax can complicate innominate vein 69 or left subclavian vein thrombosis 70 and the Fontan procedure. [71][72][73] Chylothorax can be associated with various tumors and malignancies (neurogenic, 74,75 lymphoma, 2 teratoma, 2 Wilms, 76 ovarian, 77 and Kaposi sarcoma 78 ). Lymphoma is the most common tumor associated with chylothorax (60% to 70% of cases), 2 and it may be the presenting symptom.…”