Thoracoscopic surgery for congenital lung malformations: Does previous infection really matter?
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Read the article on pubmed.ncbi.nlm.nih.gov ↗Article · Jan 2022 · 1 min read
In brief
In brief
Retrospective study of 90 pediatric patients demonstrates that thoracoscopic resection of congenital lung malformations before pulmonary infection occurs results in lower conversion rates (12.9% vs 35.7%), shorter operative times, and fewer postoperative complications. Findings support earlier elective intervention to optimize surgical outcomes.
Written by the GCMD Library team from the article.
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.
DOI: 10.1016/j.jpedsurg.2021.01.036