Thoracoscopic Versus Open Lobectomy in Infants with Congenital Lung Malformations: A Multi-institutional Propensity Score Analysis
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In brief
In brief
Multi-institutional study of 175 infants undergoing lobectomy for congenital lung malformations compared thoracoscopic versus open approaches using propensity score matching. Thoracoscopic approach showed longer operative times but reduced epidural use, with outcomes analyzed by intention-to-treat across eleven pediatric centers.
Written by the GCMD Library team from the article.
Purpose
: The impact of thoracoscopic surgery on outcomes in children with congenital lung malformations (CLM) remains controversial. The purpose of this study was to determine the effect of operative approach on perioperative outcomes in infants undergoing lobectomy for an asymptomatic CLM.
Methods
: After IRB approval, a retrospective cohort study was conducted on 506 children with a CLM resected at one of eleven children's hospitals over a seven-year period. Infants undergoing elective lobectomy were identified, and covariates were balanced based on operative approach using propensity scores with full matching. Outcomes were analyzed based on intention to treat with weighted conditional regression.
Results
: One hundred seventy-five infants met inclusion criteria. There were 67 (38.3%) open, 89 (50.9%) thoracoscopic, and 19 (10.9%) thoracoscopic-converted-to-open lobectomies. Thoracoscopic lobectomy was associated with significantly longer operative times (26 minutes, 95% CI 6-47 minutes, p=0.012) but used less epidural anesthesia (OR 0.02, 95% CI 0.004-0.11, p