New Approaches to the Surgical Treatment of Lung and Bronchial Tumors in Children

Abstract

Today, it is relevant to search for new, better methods of surgical treatment of tumors and organ-preserving and video-assisted surgery is gaining more and more popularity. The aim of the study was to improve the results of surgical treatment of children with primary and secondary (metastatic) lung tumors using high-frequency live tissue welding (HF LTW) in order to increase the treatment effectiveness. Novelty of the study lies in the expanding the knowledge of the new researched method, for enhancement of survivability relatively to chemotherapy and radiation methods, that are studied in the previous works. Advantages of the introduced method are bloodless, fast, low traumatic operations 103 case reports in children with primary and metastatic lung tumors were analyzed, including 34 patients with benign and malignant lung tumors and 69 children with metastatic bronchial and pulmonary lesions undergoing treatment from 2002 to 2018 were examined. Benign lung tumors were diagnosed in 17 patients. Malignant tumors were observed in 17 patients, including 11 lung carcinoid tumors. Metastatic bronchial and pulmonary lesions most often occurred with osteosarcoma (28) and nephroblastoma (17). In 34 children with primary tumors, 37 were undergone surgical interventions. Most often, atypical resection was used – 16 (43.3%), in particular, with carcinoid – in 7 (43.8%) patients and with hamartoma – in 4 (25%) patients. In metastatic lesions, in most cases, the same resection was performed. From 58 resections 25 (43%) were performed for osteosarcoma and 15 (26%) for nephroblastoma. The HF LTW method was used in 29 patients for benign and malignant primary tumors and in 62 (73%) surgical procedures for lung metastases to remove a tumor, vascular coagulation and sealing of the lung tissue. Using HF LTW surgical operations of different directions and volumes can be performed effectively in benign, malignant and metastatic bronchial and pulmonary lesions in children.