Earlier intervention results w/ greater success for congenital lung malformations (CLM) | 10 years | Single-institution retrospective study including all thoracoscopic lung resections for CLMs | 90 PATIENTS were included divided into two groups: | pre-op pulmonary infection | 28 patients (group A) | no pre-op pulmonary infection | 62 patients (group B) | Preoperative lung infections led to higher rate of conversion to open approach | pre-op infection (n=10) | 35.7 % | vs | no pre-op infection (n=8) | 12.9 % | (p = 0.02) | Postoperative fever seen in | 32.1% | of w/ pre-op infection | vs | 11.3% | of w/ no pre-op infection | (p = 0.03) | The operative time was significantly shorter in group B (p<0.002) | Conclusion: Earlier intervention for CLMs and avoidance of pre-op pulmonary infection may be associated with greater success of minimally invasive approach | https://pubmed.ncbi.nlm.nih.gov/33762118/ | Source: Elhattab A. et al. | Necker-Enfants malades Hospital, Paris, France | Mansoura University Children's Hospital, Mansoura, Egypt | @StayCurrentMD | @EmTombash @emencisco @RodGerardo
Thoracoscopic surgery for congenital lung malformations: Does previous infection really matter?
Infographic · Jan 2022 · 1 min read
In brief
In brief
Retrospective study of 90 pediatric patients found that prior pulmonary infection significantly increased conversion rates (35.7% vs 12.9%) and operative time during thoracoscopic resection of congenital lung malformations. Results support earlier elective intervention before infection develops to optimize surgical outcomes and reduce postoperative complications.
- Previous pulmonary infection increases conversion rate from thoracoscopic to open surgery (35.7% vs 12.9%, p=0.02)
- Earlier resection of CLMs before infection develops results in shorter operative time and reduced postoperative fever
- Patients with prior infection require antibiotics more frequently postoperatively (28.6% vs 6.5%, p=0.007)
- Elective thoracoscopic resection before infection occurs optimizes surgical outcomes and minimizes complications
- Median age at operation was higher in previously infected patients (20.4 vs 15.1 months), suggesting delayed intervention
Written by the GCMD Library team from the infographic.
A multi-panel infographic with teal and yellow color scheme. Top section features a calendar icon and patient illustrations. Middle section displays large percentage comparisons with lung illustration. Bottom section shows postoperative fever statistics and conclusion in yellow box. Social media handles and source citation at bottom.
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.