THORACOSCOPIC SURGERY FOR CONGENITAL LUNG MALFORMATIONS: DOES PREVIOUS INFECTION REALLY MATTER?
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In brief
In brief
Retrospective study of 90 pediatric patients demonstrates that prior pulmonary infection significantly impacts thoracoscopic resection of congenital lung malformations, with infected cases showing higher conversion rates (35.7% vs 12.9%), longer operative times, and increased postoperative fever. Findings support earlier elective intervention before infection develops to optimize surgical outcomes and minimize complications.
Written by the GCMD Library team from the article.
Abstract
Background/ Purpose
Elective resection of congenital lung malformations (CLMs) is still debatable. The two main risks are malignant transformation and recurrent pulmonary infections. Our study aimed to assess the effect of previous pulmonary infection on the intraoperative and postoperative courses of thoracoscopic surgery for CLMs.
Methods
This is a retrospective study including all thoracoscopic lung resections for CLMs between 2010 and 2019. Ninety patients were included. There was a history of previous pulmonary infection in 28 patients (group A) and no such history in 62 patients (group B).
Results
The median age at operation for group A was 20.4 months (IQR:14.9–41.4) versus 15.1 months (IQR:9.7–20.8) in group B (p = 0.006). There were 10 conversions (35.7%) in group A and 8 (12.9%) in group B (p = 0.02). The operative time was significantly shorter in group B (p<0.002). In group A, 32.1% of patients experienced postoperative fever versus 11.3% of group B (p = 0.03), with higher antibiotics requirement (28.6% versus 6.5% respectively, p = 0.007). However, no significant differences were found in terms of postoperative complications (p = 0.99).
Conclusion
Earlier intervention for CLMs before the development of pulmonary infection carries higher chances for the success of the thoracoscopic approach with shorter operative time and more uneventful postoperative courses.