Thoracoscopic surgery for congenital lung malformations: Does previous infection really matter?

Elsaied, Adham; Wafa, Tamer; Jugie, Myriam; Delacourt, Christophe; Sarnacki, Sabine; Aly, Kamal; Khen-Dunlop, Naziha

doi:10.1016/j.jpedsurg.2021.01.036

Cited by 19 publications

(10 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A limitation of this study is its retrospective design and relative small cohort size. Although this study is much smaller than previous published cohort series, it gives an insight in the complications in a western population, con rms the increased risk of complications in symptomatic patients and shows that this might increase in the post COVID pandemic [7,8,18]. Due to the recent COVID pandemic, most lung resections were postponed leading to more pediatric patients being managed conservatively, which will lead to an increase in symptomatic patients.…”

Section: Discussionmentioning

confidence: 76%

See 1 more Smart Citation

Surgical outcome after thoracoscopic lung resections for congenital lung lesions in children

Musters

Beer

Schuppen

et al. 2023

Preprint

View full text Add to dashboard Cite

Purpose: This study aimed to determine the complications after video assisted thoracoscopic surgery (VATS) for congenital lung lesions in children. Methods: All children undergoing a lung resection between January 2009 and June 2022 were retrospectively identified. Both early (<30 days) and late postoperative pulmonary complications were determined. The primary endpoint was postoperative complications within 30 days. Results: In total, 56 patients were included, with a median age of 13 months (IQR 9-37). A VATS lobectomy were performed in 46 patients (82%), an extralobar sequestration in 8 patients (14%), an wedge resection in 1 patient and a segment resection in 1 patient. During the COVID pandemic, less resections were performed with an increase in symptomatic patients. A conversion to open occurred in 6 patients (11%), of which a preoperative lung infection was associated with an increased risk thereof (p=0.004). The median follow-up was 22 months (IQR 7-57) and all patients were alive. A postoperative complication (Clavien Dindo ≥3) occurred in 9 patients and complications without the need of intervention in 6 patients. Conclusion: VATS lobectomy is a relatively safe procedure in children, even under one year of age. A preoperative lung infection increases the risk of conversion to open surgery.

show abstract

Section: Discussionmentioning

confidence: 76%

“…In our study the postoperative complications rate is in occurrence with other reports [7,8]. However, all procedures requiring anesthesia were included in the Clavien Dindo thee or higher classi cation.…”

Section: Discussionmentioning

confidence: 85%

Surgical outcome after thoracoscopic lung resections for congenital lung lesions in children

Musters

Beer

Schuppen

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“… 10 It is preferred to do the surgical resection between 6 months and 1 year of age, before the occurrence of pulmonary infection, which could cause local inflammation leading to more difficult surgery. 7 19 20 In our two cases, the patients were asymptomatic and referred to our department at a later age.…”

Section: Discussionmentioning

confidence: 78%

Arterial Embolization and Methylene Blue Injection into the Aberrant Artery in Two Infants with Intralobar Sequestration

Accarain

Laureys

Joyeux

et al. 2022

European J Pediatr Surg Rep.

View full text Add to dashboard Cite

Bronchopulmonary sequestration is a rare congenital lung dysplasia. An intralobar sequestration (ILS) is a nonfunctional mass within the lung parenchyma without bronchial communication and with aberrant systemic arterial blood supply. Surgical resection or close observation can be proposed in the management of asymptomatic and low-risk ILS, but there is a lack of consensus. Endovascular embolization before thoracoscopic resection of ILS has been described to limit perioperative bleeding. Another technique previously reported is the injection of methylene blue in the feeding artery to macroscopically mark the sequestration from the healthy lung. In that way, a nonanatomical resection can be performed instead of a lobectomy without the risk of leaving abnormal lung tissue in place. We describe the first two cases of these two techniques combined: a 3-year-old girl with an ILS in the right lower lobe with an artery originating from the abdominal aorta, and a 14-month-old girl with an ILS in the right lower lobe with an artery coming from the celiac trunk.The combination of embolization and injection of methylene blue in the aberrant artery leads to a clear macroscopic demarcation of the blue-colored ILS from the healthy lung parenchyma and allowed safe nonanatomical resection of the ILS without risk of bleeding or compromising normal lung tissue.

show abstract

“…Our findings are supported by those of previous retrospective studies [ 8 , 12 ]. Elhattab and colleagues found a lower conversion rate to thoracotomy and postsurgical complications among asymptomatic patients than among patients with previous pulmonary infection [ 13 ]. Parish and colleagues also reported that postoperative complications were higher in infected lesions [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

Previous pulmonary infection impacts thoracoscopic procedure outcomes in patients with congenital lung malformations: a retrospective cohort study

et al. 2023

View full text Add to dashboard Cite

Background and objectives Patients with congenital lung malformations (CLMs) are at high risk for developing pulmonary infection. Nonetheless, prophylactic surgical excision of asymptomatic CLMs is controversial and often delayed to symptoms occurring out of concern for potential operative risks. This study aims to evaluate the impact of previous pulmonary infection on the outcome of thoracoscopic procedures in CLMs patients. Methods This was a retrospective cohort study of CLMs patients who received an elective operation at a tertiary care center from 2015 to 2019. Patients were divided into pulmonary infection (PI) or non-infection of pulmonary (NPI) groups according to the history of pulmonary infection. Propensity score matching was used to minimize the bias between groups. The primary outcome was conversion to thoracotomy. Postoperative outcomes were compared between patients with and without PI. Results We identified 464 patients, of whom 101 had a history of PI. Propensity score matching yielded a well-balanced cohort of 174 patients. PI was associated with higher conversion to thoracotomy (adjusted odds ratio = 8.7, 95% confidence interval, CI, 1.1–71.2, p = 0.039), blood loss (p = 0.044), and longer operative time (p < 0.001), chest tube placement time (p < 0.001), length of stay (p < 0.001), and postsurgical length of stay (p < 0.001). Conclusions Elective operation in CLMs patients with a history of PI was associated with an increased risk of conversion to thoracotomy, operative time, blood loss, chest tube placement time, length of stay, and postsurgical length of stay. Elective thoracoscopic procedures in asymptomatic CLMs patients are safe and effective, and earlier surgical intervention may be warranted.

show abstract

Thoracoscopic surgery for congenital lung malformations: Does previous infection really matter?

Cited by 19 publications

References 33 publications

Surgical outcome after thoracoscopic lung resections for congenital lung lesions in children

Surgical outcome after thoracoscopic lung resections for congenital lung lesions in children

Arterial Embolization and Methylene Blue Injection into the Aberrant Artery in Two Infants with Intralobar Sequestration

Previous pulmonary infection impacts thoracoscopic procedure outcomes in patients with congenital lung malformations: a retrospective cohort study

Contact Info

Product

Resources

About