Objective: Video-assisted thoracoscopic surgery (VATS) is now widely p
ractised in adults but there are few publications on its application i
n the paediatric population. Methodology: Retrospective review of the
authors' experience with VATS in children under 16 years old during an
18 month period in a university teaching hospital. Results: From Sept
ember 1993 to March 1994, VATS was attempted in 14 patients. Five were
unsuccessful because of pleural symphysis or inability to collapse th
e upper lung. Ten cases of VATS were successfully performed in the rem
aining nine patients (eight males, one female; age range from 22 days
to 15 years old). These included two drainages and limited decorticati
ons for loculated pleural effusion, one guided drainage of pericardial
effusion, one thymectomy for thymic hyperplasia, three wedge resectio
ns for metastatic pulmonary osteosarcoma and three bleb excisions and
pleurodesis for primary spontaneous pneumothoraces. There were no intr
a-operative complications. There was one death from dysrhythmia follow
ing an uneventful wedge resection. The mean duration of chest tube dra
inage was 1.4 days and postoperative hospital stay 2.6 days excluding
two patients who stayed for further medical treatment. Conclusion: VAT
S is a useful approach in selected cases but further development of th
is approach awaits refinement of anaesthetic technique and endoscopic
instrumentation.