Abstract
PURPOSE: To compare the clinical outcomes of "Single Surgeon" and "Single Site" total thoracoscopic surgery with multi-portal video-assisted thoracic surgery (M-VATS) in the treatment of paediatric extralobar sequestration (ELS), and to evaluate its safety and feasibility in routine practice. METHODS: We retrospectively analysed 51 paediatric ELS cases treated thoracoscopically at our institution from January 2020 to March 2025. Patients were grouped by surgical approach: 18 underwent single-site thoracoscopy, and 33 underwent M-VATS. Clinical parameters were compared between groups. RESULTS: Compared to M-VATS, the single-site group showed significantly reduced operative time (P = 0.02), blood loss (P < 0.01), hospital stay (P < 0.01), and expenses (P < 0.01). No bronchopleural fistulas, postoperative pneumonia, or conversions to open surgery occurred in either group. CONCLUSIONS: "Single Surgeon" and "Single Site" thoracoscopic surgery offers distinct advantages, including minimized incisions, faster recovery, and reduced resource consumption, aligning with modern minimally invasive and enhanced recovery practices. The technique demonstrates safety, efficiency, and cost-effectiveness, supporting its broader clinical adoption.