Jintao Zheng1, Huajian Tang2, Huiyu Xu2, Jiequan Li2, Xiangming Mao3, Guoqing Liu4. 1. Department of Neonatal and Pediatric Surgery, Chancheng District, Foshan Women and Children Hospital Affiliated to Southern Medical University, No. 11 West Renmin Rd, Foshan City, 528000, Guangdong, China. zheng-jintao@foxmail.com. 2. Department of Neonatal and Pediatric Surgery, Chancheng District, Foshan Women and Children Hospital Affiliated to Southern Medical University, No. 11 West Renmin Rd, Foshan City, 528000, Guangdong, China. 3. Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, Guangdong, China. mxm631221@126.com. 4. Department of Neonatal and Pediatric Surgery, Chancheng District, Foshan Women and Children Hospital Affiliated to Southern Medical University, No. 11 West Renmin Rd, Foshan City, 528000, Guangdong, China. liuguoqing-fs@hotmail.com.
Abstract
PURPOSE: The purpose of this study is to evaluate the potential advantages of thoracoscopic versus open resection for symptomatic congenital pulmonary airway malformation (CPAM) in neonates. METHODS: A retrospective review of the medical records of neonates (age ≤ 28 days) who underwent surgery for symptomatic CPAM from 2010 to 2020. RESULTS: Of the 24 patients, 14 patients underwent thoracoscopic resection and 10 patients underwent open resection. 4 patients with CPAM located in the upper or middle lobes underwent lobectomy, and 20 underwent lung-preserving wedge resection in the lower lobe. Between the two groups, there were no statistically significant differences in related preoperative variables, including gestational age at birth, body weight, head circumference, lesion size, cystic adenomatoid malformation volume ratio (CVR), and age at operation (P > .05). The differences in intraoperative variables were statistically significant. The length of the surgical incision was significantly shorter in thoracoscopic resection group than in open resection group (1.4 cm [1.3-1.8] vs. 6.0 cm [5.0-8.0], P = .000), along with significantly less operative blood loss (3 ml [1-6] vs. 5 ml [2-10], P = .030) but significantly longer operation time (159 min [100-220] vs. 110 min [70-170], P = .003). Regarding postoperative variables, ventilator days, duration of chest tube use and length of hospital stay were not statistically significant (P > .05). CONCLUSION: Both thoracoscopic and open resection for symptomatic CPAM achieve good clinical outcomes, even in neonates. Thoracoscopic resection has minimal aesthetic effects and does not increase the risk of surgical or postoperative complications. Lung-preserving resection may be feasible for neonatal CPAM surgery.
PURPOSE: The purpose of this study is to evaluate the potential advantages of thoracoscopic versus open resection for symptomatic congenital pulmonary airway malformation (CPAM) in neonates. METHODS: A retrospective review of the medical records of neonates (age ≤ 28 days) who underwent surgery for symptomatic CPAM from 2010 to 2020. RESULTS: Of the 24 patients, 14 patients underwent thoracoscopic resection and 10 patients underwent open resection. 4 patients with CPAM located in the upper or middle lobes underwent lobectomy, and 20 underwent lung-preserving wedge resection in the lower lobe. Between the two groups, there were no statistically significant differences in related preoperative variables, including gestational age at birth, body weight, head circumference, lesion size, cystic adenomatoid malformation volume ratio (CVR), and age at operation (P > .05). The differences in intraoperative variables were statistically significant. The length of the surgical incision was significantly shorter in thoracoscopic resection group than in open resection group (1.4 cm [1.3-1.8] vs. 6.0 cm [5.0-8.0], P = .000), along with significantly less operative blood loss (3 ml [1-6] vs. 5 ml [2-10], P = .030) but significantly longer operation time (159 min [100-220] vs. 110 min [70-170], P = .003). Regarding postoperative variables, ventilator days, duration of chest tube use and length of hospital stay were not statistically significant (P > .05). CONCLUSION: Both thoracoscopic and open resection for symptomatic CPAM achieve good clinical outcomes, even in neonates. Thoracoscopic resection has minimal aesthetic effects and does not increase the risk of surgical or postoperative complications. Lung-preserving resection may be feasible for neonatal CPAM surgery.
Authors: Eric B Jelin; Elizabeth M O'Hare; Tim Jancelewicz; Isam Nasr; Emily Boss; Daniel S Rhee Journal: J Pediatr Surg Date: 2018-02-10 Impact factor: 2.545
Authors: Hong Kwan Kim; Yong Soo Choi; Kwhanmien Kim; Young Mog Shim; Gwan Woo Ku; Kang-Mo Ahn; Sang Il Lee; Jhingook Kim Journal: Ann Thorac Surg Date: 2008-07 Impact factor: 4.330
Authors: Francesco Fascetti-Leon; Dalia Gobbi; Stefania Valentina Pavia; Antonio Aquino; Giovanni Ruggeri; Giulio Gregori; Mario Lima Journal: J Pediatr Surg Date: 2013-07 Impact factor: 2.545
Authors: Federica Annunziata; Andrew Bush; Francesco Borgia; Francesco Raimondi; Silvia Montella; Marco Poeta; Melissa Borrelli; Francesca Santamaria Journal: Front Pediatr Date: 2019-06-13 Impact factor: 3.418
Authors: Dandan Liu; Gang Zhang; Jianyi Liao; Lan Jiang; Chun Cai; Xiao Li; Lei Lou; Bin Zhou; Huiyi Zeng; Xiangang Yan; Gang Yu Journal: Comput Intell Neurosci Date: 2022-08-18