Abstract: Objective To summarize the operation process of “single-surgeon double-incision method” in video-assisted thoracoscopic surgery in the treatment of the children with extralobar sequestration, and to evaluate the feasibility and safety of this operation. Methods The clinical data of 45 patients operated on by the same surgeon in the Childrens Hospital Affiliated to Shandong University during Jan. 2020 and Aug. 2023 were retrospectively collected. According to different surgical methods, the patients were divided into double-incision group(n=15, 11 males and 4 females, aged 4 to 19 months)and three-incision group(n=30, 21 males and 9 females, aged 3 to 59 months). The operation time, intraoperative blood loss, hospital stay, hospital costs and incidence of postoperative complications were compared with rank-sum test, t test and Fisher exact test. Results All operations were successfully completed, without conversion to open surgery. The double-incision group had lower hospital costs(31,165 vs. 35,555 Yuan, t=-6.093, P<0.001), shorter operation time(40 vs. 45 min, z=-2.322, P=0.020), shorter hospital stay(5 vs. 6 d, z=-3.519, P<0.001), and shorter length of chest wall incision(1.0 vs. 1.6 cm, z=-5.489, P<0.001). There were no significant differences in the amount of intraoperative blood loss and incidence of postoperative complications between the two groups. Conclusion Single-surgeon double-incision method is simple, safe and feasible in minimally invasive video-assisted thoracoscopic surgery in the treatment of the children with extralobar sequestration, which reduces the operation time, hospital stay, length of chest wall incision, and hospital costs. It is in line with the concept of enhanced recovery after surgery, and worthy of promotion and application in clinical practice.

Key words: Double-incision thoracoscope, Extralobar sequestration, Children, Minimally invasive, Enhanced recovery after surgery