Girolamo Mattioli1, Luca Pio2, Nicola Massimo Disma3, Michele Torre4, Oliviero Sacco5, Angela Pistorio6, Clelia Zanaboni3, Giovanni Montobbio3, Fabio Barra4, Luca Antonio Ramenghi7. 1. Pediatric Surgery Unit, Istituto Giannina Gaslini, Genoa, Italy; DINOGMI, University of Genoa, Genoa, Italy. 2. Pediatric Surgery Unit, Istituto Giannina Gaslini, Genoa, Italy; DINOGMI, University of Genoa, Genoa, Italy. Electronic address: lucakeats@hotmail.it. 3. Pediatric Anesthesia Unit, Istituto Giannina Gaslini, Genoa, Italy. 4. Pediatric Surgery Unit, Istituto Giannina Gaslini, Genoa, Italy. 5. Pediatric Pulmonology Unit, Istituto Giannina Gaslini, Genoa, Italy. 6. Epidemiology and Biostatistics Service, Istituto Giannina Gaslini, Genoa, Italy. 7. Neonatal Intensive Care Unit, Istituto Giannina Gaslini, Genoa, Italy.
Abstract
BACKGROUND: Over the years the need for surgical treatment, timing of intervention, and the type of surgical approach have been discussed, but the treatment of congenital lung malformations remains controversial. The aim of this study was to compare the thoracotomy approach with the thoracoscopic technique by evaluating different surgical outcomes (duration of surgery, postoperative hospital stay, and complications). METHODS: All patients operated from January 2011 to March 2015 for suspected congenital cystic lung were included in the study. Patients treated for congenital lobar emphysema and tracheobronchial neoplasms were excluded from the study. RESULTS: In the analyzed period, 31 asymptomatic patients were treated: 18 lung resections were performed with thoracotomy (Group A) and 13 with the thoracoscopic approach (Group B). No significant differences were observed between the age and weight at surgery, length of the procedures, complications, and the need for postoperative intensive care between the two groups. The postoperative hospital stay in Group A was twice that for Group 2 (p = 0.0009). CONCLUSION: Comparing thoracoscopic surgery with the traditional open approach, we confirmed the superiority of minimally invasive treatment in terms of postoperative hospital stay. Common technical recommendations can help pediatric centers to develop the thoracoscopic approach for the treatment of congenital pulmonary malformations.
BACKGROUND: Over the years the need for surgical treatment, timing of intervention, and the type of surgical approach have been discussed, but the treatment of congenital lung malformations remains controversial. The aim of this study was to compare the thoracotomy approach with the thoracoscopic technique by evaluating different surgical outcomes (duration of surgery, postoperative hospital stay, and complications). METHODS: All patients operated from January 2011 to March 2015 for suspected congenital cystic lung were included in the study. Patients treated for congenital lobar emphysema and tracheobronchial neoplasms were excluded from the study. RESULTS: In the analyzed period, 31 asymptomatic patients were treated: 18 lung resections were performed with thoracotomy (Group A) and 13 with the thoracoscopic approach (Group B). No significant differences were observed between the age and weight at surgery, length of the procedures, complications, and the need for postoperative intensive care between the two groups. The postoperative hospital stay in Group A was twice that for Group 2 (p = 0.0009). CONCLUSION: Comparing thoracoscopic surgery with the traditional open approach, we confirmed the superiority of minimally invasive treatment in terms of postoperative hospital stay. Common technical recommendations can help pediatric centers to develop the thoracoscopic approach for the treatment of congenital pulmonary malformations.