Single Site Thoracic Surgery for Pediatric Pneumothorax

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.

• Conventional multiport thoracoscopic surgery (Procedure), also known as Video assisted thoracoscopic surgery, multi-incisions: Use 2 or more incisions for multiple instrument entry during the surgery and chest tube placement at the end of the operation.
• Single port site thoracoscopic surgery (Procedure), also known as Single incision video assisted 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)

Primary outcomes

• 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 outcomes

• 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.

Sex: All, ages: any to 19 Years

Inclusion Criteria:

* Age < 19 years old
* pneumothorax
* underwent surgery for pneumothorax

Exclusion Criteria:

* Age =/> 19 years old
* history of prior thoracic surgery
* history of cancer

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• Andrei Radulescu, MD, PhD, Principal investigator, Loma Linda University