Single Site Thoracic Surgery for Pediatric Pneumothorax
Study Details
Study Description
Brief Summary
Video-Assisted Thoracoscopic Surgery (VATS) has become a standard of care in adults, pediatric surgeons have been slower to undertake this approach. There are limitations for working in children. The site of a chest tube becomes the working site for thoracoscopic surgery and the only scar. We propose this study to do a retrospective review comparing the conventional multiport thoracic surgery with the newer single port site.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
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Detailed Description
While Video-Assisted Thoracoscopic Surgery (VATS) has become a standard of care in adults, pediatric surgeons have been slower to undertake this approach. The limitations for working in children are decreased working space, unknown thoracoscopic effects on body physiology, and instrument accommodation. Especially as the field for minimally invasive surgery expands, using the single port approach has unique implications in children. The site of a chest tube becomes the working site for thoracoscopic surgery and the only scar. Despite some learning curve, the preliminary outcomes are similar to the multiport surgeries with better cosmesis. The learning curves for single port site surgery have been well described and our group recently performed a similar study for appendectomies. We propose this study to do a retrospective review comparing the conventional multiport thoracic surgery with the newer single port site.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Conventional Multiport Thoracoscopic Surgery for Pediatric Pneumothorax Patients who had multiport video assisted thoracoscopic surgery for pediatric pneumothorax. |
Procedure: Conventional multiport thoracoscopic surgery
Use 2 or more incisions for multiple instrument entry during the surgery and chest tube placement at the end of the operation.
Other Names:
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| Single Port Thoracoscopic Surgery for Pediatric Pneumothorax Patients who had single port video assisted thoracoscopic surgery for pediatric pneumothorax. |
Procedure: Single port site thoracoscopic surgery
Using only 1 incision for multiple instrument entry during the surgery and chest tube placement at the end of the operation. Single port - GelPOINT Mini® port (Applied Medical, Rancho Santa Margarita, California, USA)
Other Names:
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Outcome Measures
Primary Outcome Measures
- Total amount of opioid doses in 24 hours post-op [24 hours post-operative VATS procedure]
Pain medication records will be reviewed for all opioids dispensed during the post-operative period until time of discharge. The name of the opioid, the dosage, the route, and the frequency will be recorded.period until time of discharge. The name of the opioid, the dosage, the route, and the frequency will be recorded.
- Assessment of length of time of chest tube insertion [Time from surgery until chest tube removal]
Time will be recorded from surgery until chest tube removal post operation.
Secondary Outcome Measures
- Assessment of operation time [The time from surgery incision start to surgery closing will be the end time.]
The length of surgery will be recorded.
- Assessment of pneumothorax reoccurrence [Within 48 hours post-operative period after surgery.]
If a pneumothorax occurs in the post-operative period, this will be recorded.
- Total opioid dose from surgery until discharge [Within 72 hours post-operative period after surgery.]
Pain medication records will be reviewed for all opioids dispensed during the period from start of surgery through time of hospital discharge. The name of the opioid, the dosage, the route, and the frequency will be recorded.
Eligibility Criteria
Criteria
Inclusion Criteria:
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Age < 19 years old
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pneumothorax
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underwent surgery for pneumothorax
Exclusion Criteria:
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Age =/> 19 years old
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history of prior thoracic surgery
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history of cancer
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Loma Linda University | Loma Linda | California | United States | 92350 |
Sponsors and Collaborators
- Loma Linda University
Investigators
- Principal Investigator: Andrei Radulescu, MD, PhD, Loma Linda University
Study Documents (Full-Text)
None provided.More Information
Publications
- Fernandez-Pineda I, Seims AD, VanHouwelingen L, Abdelhafeez H, Wu H, Wu J, Murphy AJ, Davidoff AM. Modified Uniportal Video-Assisted Thoracic Surgery Versus Three-Port Approach for Lung Nodule Biopsy in Pediatric Cancer Patients. J Laparoendosc Adv Surg Tech A. 2019 Mar;29(3):409-414. doi: 10.1089/lap.2018.0120. Epub 2018 Nov 10.
- Goodman LF, Lin AC, Sacks MA, McRae JJLH, Radulescu A, Khan FA. Single site versus conventional laparoscopic appendectomy: some pain for no gain? J Surg Res. 2021 Aug;264:321-326. doi: 10.1016/j.jss.2021.03.010. Epub 2021 Apr 10.
- Martynov I, Lacher M. Homemade Glove Port for Single-Incision Pediatric Endosurgery (SIPES) Appendectomy-How We Do It. European J Pediatr Surg Rep. 2018 Jan;6(1):e56-e58. doi: 10.1055/s-0038-1667140. Epub 2018 Jul 24.
- Song IH, Lee SY, Lee SJ. Can single-incision thoracoscopic surgery using a wound protector be used as a first-line approach for the surgical treatment of primary spontaneous pneumothorax? A comparison with three-port video-assisted thoracoscopic surgery. Gen Thorac Cardiovasc Surg. 2015 May;63(5):284-9. doi: 10.1007/s11748-015-0522-2. Epub 2015 Jan 29.
- Zimmermann P, Martynov I, Perger L, Scholz S, Lacher M. 20 Years of Single-Incision-Pediatric-Endoscopic-Surgery: A Survey on Opinion and Experience Among International Pediatric Endosurgery Group Members. J Laparoendosc Adv Surg Tech A. 2021 Mar;31(3):348-354. doi: 10.1089/lap.2020.0797. Epub 2020 Dec 31.
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