A modern approach to multiple pulmonary resections in children with recurrent metastatic pulmonary disease

• Published in: Pediatric blood & cancer Vol. 71; no. 11; pp. e31304 - n/a
• Main Authors: Shah, Nikhil R., Williams, Keyonna M., Stoll, Tammy, Heider, Amer, Opipari, Valerie P., Jasty Rao, Rama, Newman, Erika A., Ehrlich, Peter F., Geiger, James D.
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.11.2024
• Subjects: Children; Complications; Lung diseases; Metastases; metastasis; Osteosarcoma; pediatric surgical oncology; Postoperative; pulmonary resection; Respiratory function; Survival; thoracoscopy; thoracotomy; pediatric surgical oncology; thoracotomy; thoracoscopy; metastasis; pulmonary resection
• ISSN: 1545-5009; 1545-5017; 1545-5017
• DOI: 10.1002/pbc.31304

Implications of repeated resections of pulmonary metastasis (PM) are not well documented in the modern era. Fifteen children underwent two (n = 8), three (n = 3), or four or more (n = 3) resections (total = 38 procedures), most commonly for osteosarcoma (71%). Operative approach included muscle‐sparing thoracotomy (71%), non‐muscle‐sparing thoracotomy (18%), and video‐assisted thoracoscopy (11%). Median resected nodules per procedure was four (range = 1–95). Prolonged air leaks were the most common postoperative complication (29%). Median hospital stay was 4 days, and no children were discharged with or have required oxygen. Event‐free survival is 67% at median follow‐up time of 54 months, with an overall survival rate of 64%. Repeat resection of PM appears to be well tolerated, without prolonged hospital stays or compromised pulmonary function.