Use of the Harmonic Blade Scalpel as a Novel Technique for Thoracoscopic Resection of Pediatric Paraspinal Masses in Children

Abstract

Abstract

Introduction:

Data support use of video-assisted thoracoscopic surgery (VATS) for safe and effective resection of paraspinal masses in children. Our aim was to describe outcomes following this operation using a novel technique and to compare its use with that of other established techniques.

Subjects and Methods:

We performed a retrospective chart review of all children (<18 years old) undergoing thoracoscopic resection of paraspinal masses in 2000–2011. Demographics, operative details, and clinical outcomes were summarized and compared between those undergoing resection using a Harmonic^® (Ethicon Endo-Surgery, Blue Ash, OH) blade scalpel (HBS) and those who did not.

Results:

Sixteen cases were identified (median age, 57.5 months; range, 2–204 months). Six cases (37%) underwent VATS with use of the HBS, and 10 (63%) did not. Demographic and clinical factors were well matched. Median tumor diameter was larger in the HBS group (49.2 cm³ versus 18.7 cm³; P=.07). Operative time was similar between groups (121 versus 138 minutes; P=.25), as was the estimated blood loss (10 mL versus 30 mL; P=.91) and chest tube duration (2.1 versus 1.8 days; P=.78). Three cases of Horner's syndrome developed in the standard resection group, and one complication occurred in the HBS group.

Conclusions:

The Harmonic blade scalpel can be used as a simple alternative to standard dissection techniques for thoracoscopic resection of paraspinal masses in children.