Objective  To investigate the safety and feasibility of thoracoscopic anatomical pulmonary segmentectomy in children with congenital lung malformations.

  Methods  A retrospective review was conducted to analyze clinical data of children thoracoscopic anatomical pulmonary segmentectomy performed in West China Hospital of Sichuan University from Jan. 2014 to Sept. 2018.

  Results  A total of 151 cases were recorded, including 73 males and 78 females. The average age was 9.8 months, ranging from 5 months to 13.3 years. All the patients underwent thoracoscopic surgery without conversion to open. The average operation time was 66 min, the average amount of bleeding was 5.9 mL and the average size was 4.8 cm. Two children had air leakage after the operation, but recovered after one-week tube drainage and conservative observation therapy. 56 children had postoperative fever in varying degrees, which gradually recovered 2-3 d after operation. No postoperative complications occurred such as bronchial fistula, hemorrhage, atelectasis and pulmonary infection. Postoperative pathological results showed that there were 108 cases of congenital pulmonary airway malformation and 43 cases of intralobar pulmonary sequestration. The median follow-up time was chest computed tomography of follow-up showed that all patients recovered well without recurrence.

  Conclusion  On the basis of thoracoscopic meticulous anatomy of lung lobes, Thoracoscopic anatomical segmentectomy in children is safe and feasible as a lung sparing resection.