Single Site Thoracic Surgery for Pediatric Pneumothorax

Study Overview
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Brief Summary
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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.

Detailed Description
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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.

Official Title
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Pain Versus Gain: Multiport Versus Single-Port Thoracoscopic Surgery for Pediatric Pneumothorax a Case Series

Conditions
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Pediatric Disorder, Pneumothorax, Spontaneous, Thoracic Diseases, Thoracic Surgery

Intervention / Treatment
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* Procedure: Conventional multiport thoracoscopic surgery
* Procedure: Single port site thoracoscopic surgery


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Maximum Age: 19 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Conventional Multiport Thoracoscopic Surgery for Pediatric Pneumothorax<br>Patients who had multiport video assisted thoracoscopic surgery for pediatric pneumothorax. | Procedure: Conventional multiport thoracoscopic surgery<br>* Use 2 or more incisions for multiple instrument entry during the surgery and chest tube placement at the end of the operation.<br>* Other names: Video assisted thoracoscopic surgery, multi-incisions;|
| Single Port Thoracoscopic Surgery for Pediatric Pneumothorax<br>Patients who had single port video assisted thoracoscopic surgery for pediatric pneumothorax. | Procedure: Single port site thoracoscopic surgery<br>* 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)<br>* Other names: Single incision video assisted thoracoscopic surgery;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Total amount of opioid doses in 24 hours post-op | 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. | 24 hours post-operative VATS procedure | 
| Assessment of length of time of chest tube insertion | Time will be recorded from surgery until chest tube removal post operation. | Time from surgery until chest tube removal | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Assessment of operation time | The length of surgery will be recorded. | The time from surgery incision start to surgery closing will be the end time. | 
| Assessment of pneumothorax reoccurrence | If a pneumothorax occurs in the post-operative period, this will be recorded. | Within 48 hours post-operative period after surgery. | 
| Total opioid dose from surgery until discharge | 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. | Within 72 hours post-operative period after surgery. |