OBJECTIVE To estimate the value of video-assisted thoracoscopic surgery (VATS) in diagnosis and treatment of children with chest diseases. METHODS From May 1997 to October 2001, forty-one children (25 boys and 16 girls) with chest diseases received VATS under
general anesthesia in our hospital. Their average age was 6.9 years (range 9 days to 16 years) and their median
body weight was 22.5 kg (2.8-54.0 kg). Operative procedures included fibrinopurulent
empyema with
debridement and decortication in 15 children, biopsy and(or) resection of mediastinal
tumor in 11, bullectomy and
cystectomy of the lung in 6, lobectomy with huge
cyst of the lung or sequestration in 5, clearance of
hemothorax in 2, and exploration, and repair of
diaphragmatic hernia in 2. RESULTS The mean
operative time was 74 minutes (range 30 to 220 minutes). The lost blood volume was 33 ml (range 10 to 150 ml). The mean duration of chest drainage and
hospital stay after surgery was 2.4 days and 7.0 days (range 4 to 15 days) respectively. One infant born after 9 days with congenital diaphragmatocele died of
respiratory failure due to left pulmonary hypoplasia 10 days after operation. Postoperative morbidity was 7.3% (3 patients). Forty patients were followed up for an average of 15.6 months, 38 patients lived and developed normally, and 2 received
chemotherapy. CONCLUSION Video-assisted thoracoscopy is a safe and effective diagnostic and therapeutic procedure for children with chest disease, and this approach has an important place in pediatric thoracic surgery.