Thoracoscopic Approach to Pulmonary Parenchymal Lesions

Abstract

Thoracoscopy in children was originally described for biopsy of diffuse pulmonary infiltrates. The application of these techniques to other pulmonary parenchymal lesions is now a well-established, reliable alternative to traditional open thoracotomy. The technique has been used successfully for diagnosis of diffuse and localized infiltrates of uncertain etiology. Diagnostic biopsies may be obtained safely and accurately with minimal morbidity and at comparable or lower overall cost than thoracotomy. Discrete parenchymal nodules, either solitary or multiple, are also amenable to thoracoscopic resection. The literature reports complete evaluation and resection of selected lung lesions with equivalent follow-up results. Hospital stay and duration of chest tube drainage are shorter for thoracoscopy than for open thoracotomy, and therefore, the overall cost is lower. Although thoracoscopy may be limited somewhat by patient size and ability to tolerate unilateral ventilation, it has become the procedure of choice in suitable patients undergoing lung biopsy or resection of nodules.