Thoracoscopic versus open resection of congenital lung lesions: a case-matched study

• Published in: Journal of pediatric surgery Vol. 42; no. 6; pp. 1057 - 1061
• Main Authors: Diamond, Ivan R, Herrera, Patricio, Langer, Jacob C, Kim, Peter C.W
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2007
• Subjects: Case-Control Studies; Chest Tubes - utilization; Congenital Abnormalities - surgery; Cystic Adenomatoid Malformation of Lung, Congenital - surgery; Feasibility Studies; Female; Humans; Infant; Infant, Newborn; Length of Stay - statistics & numerical data; Lung - abnormalities; Male; Narcotics - therapeutic use; Pain, Postoperative - drug therapy; Pain, Postoperative - epidemiology; Pediatrics; Pneumonectomy - methods; Pneumonectomy - statistics & numerical data; Postoperative Complications - epidemiology; Retrospective Studies; Surgery; Thoracoscopy - statistics & numerical data; Thoracotomy - statistics & numerical data; Treatment Outcome; Thoracoscopy; Comparative study; Congenital genital lung lesions
• ISSN: 0022-3468; 1531-5037
• DOI: 10.1016/j.jpedsurg.2007.01.043

Abstract Purpose The purpose of the study was to compare the outcomes in children undergoing thoracoscopic versus open resection of congenital lung lesions. Methods Retrospective review of 12 consecutive children (<3 years of age) undergoing thoracoscopic resection of a congenital lung lesion between 2004 and 2005 was performed. Intraoperative and early postoperative results were compared with randomly selected age- and sex-matched (2:1) patients undergoing thoracotomy between 2000 and 2005. Results Twelve children underwent thoracoscopic resection and were compared with 24 that underwent thoracotomy. Seventy five percent of the lesions in both groups were congenital cystic adenomatoid malformations. There were no major intraoperative complications. Two thoracoscopic procedures were converted to a thoracotomy. Perioperative outcomes including operative time, length of stay, duration and volume of chest tube drainage, and dose and duration of intravenous opioids were similar for the procedures. However, children undergoing thoracoscopic procedures were less likely (odds ratio = 0.07) to have received adjunctive regional anesthesia. Overall morbidity was 33% thoracoscopic and 25% open ( P = .70). Conclusion Thoracoscopic resection is a safe and feasible alternative to open resection of congenital lung lesions. Examination of long-term advantages of the thoracoscopic approach such as decreased risk of chest wall deformity and scoliosis and improved cosmesis will require longer follow-up.