Medium-Term Pulmonary Function Test After Thoracoscopic Lobectomy and Segmentectomy for Congenital Lung Malformation: A Comparative Study With Normal Control

Abstract

Purpose: This study aimed to compare the outcomes and pulmonary function test (PFT) of thoracoscopic segmentectomy and lobectomy in infants with congenital lung malformation and study the result of PFT on a medium-term basis.Methods: The clinical data of 19 infants with congenital lung malformation who underwent thoracoscopic surgery in our hospital from January 2018 to March 2019 were retrospectively studied; these infants were paired with another 19 infants who underwent thoracoscopic lobectomy during the same period using propensity score matching. Age-matched healthy individuals with similar body sizes were recruited for PFT as the control group. Patient characteristics, postoperative PFT, and outcomes were extracted for statistical analysis.Results: The average length of hospital stay did not significantly differ between segmentectomy and lobectomy groups. The segmentectomy group had more chest tube drainage than the lobectomy group. PFT 1 month after the operation showed that the tidal volume of the lobectomy group was lower than that of the segmentectomy group. Time to peak expiratory flow/time of expiration and peak flow/terminal airway velocity (V25%) indicated small airway dysfunction in the lobectomy group, and no obvious abnormalities were found in “time of inspiratory/time of expiration” in either group. Reexamination of pulmonary function 2 years after the operation showed that the small airway function of the segmentectomy group returned to normal, and no significant difference in pulmonary function was noted among the three groups.Conclusion: The short-term pulmonary function recovery was better after segmentectomy than after lobectomy. Patients who underwent thoracoscopic lobectomy and segmentectomy have normal lung function 2 years after the operation.

Ten‐year experience in the clinical management of intralobar pulmonary sequestration in children

“…Therefore, the resection of normal lung tissue should be reduced, which can preserve the normal lung volume and lung function. 10 TALR has a great advantage in this regard, as mentioned in our recently published report. 11 The key to this surgical approach was to segment the boundary between normal and lesion tissue (Figure 3).…”

“…As a congenital benign disease, ILS does not have the features of invasion or metastasis. Therefore, the resection of normal lung tissue should be reduced, which can preserve the normal lung volume and lung function 10 . TALR has a great advantage in this regard, as mentioned in our recently published report 11 .…”

Modified thoracoscopic wedge resection of limited peripheral lesions in S10 for children with congenital pulmonary airway malformation: Initial single-center experience

“…With the development of minimally invasive technology, thoracoscopic lobectomy has become the main surgical method for the treatment of CPAM. For localized peripheral lesions, although lobectomy can completely remove the lesions, it leads to the loss of a large amount of normal lung tissue, which is not conducive to the recovery of lung function and long-term prognosis ( 6 , 10 ). Some experts have proposed lung-sparing surgery, which aims to maximize the preservation of normal lung tissue after resecting lesions.…”

Thoracoscopic segmentectomy for congenital pulmonary airway malformation arising in a lung with an accessory fissure: A case report

“…Thoracoscopic lobectomy is the most commonly performed surgery for pediatric patients with CPAM because a complete resection of the affected lobe reduces the risk of residual disease 4 . Compared with lobectomy, segmentectomy preserves pulmonary function and allows compensatory lung growth following lung parenchymal resection 5,6 . However, it is difficult to recognize the anatomical structural variations of the vessels and bronchi preoperatively because of the limited operative field in the thoracic cavity.…”

“…4 Compared with lobectomy, segmentectomy preserves pulmonary function and allows compensatory lung growth following lung parenchymal resection. 5,6 However, it is difficult to recognize the anatomical structural variations of the vessels and bronchi preoperatively because of the limited operative field in the thoracic cavity. In the present case, the affected lung tissue was limited to S6 with the accessory fissure.…”