Short-term outcomes of thoracoscopic versus open lobectomy for congenital lung malformations

Steven L. Raymond, Marla A. Sacks, Asra Hashmi, Jason O. Robertson, Donald Moores, Edward P. Tagge, Andrei Radulescu, Saleem Islam, Faraz A. Khan

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Thoracoscopic and open approaches for the management of congenital lung malformations (CLM) has been debated. The aim of this study is to compare 30-day outcomes for non-emergent lobectomies in children. Methods: The National Surgical Quality Improvement Program-Pediatric database was queried for patients undergoing CLM resection from 2013 to 2020. Outcomes were compared by operative technique in an intention-to-treat model and then propensity matched. Results: 2157 patients met inclusion criteria and underwent non-emergent pulmonary lobectomy for CLM. The intended operative approach was thoracoscopic in 57.7% of patients. Patients in the open group compared to the thoracoscopic were more likely to be born premature, have chronic lung disease, require preoperative oxygen support, and be ventilator dependent. After propensity matching, there was no statistically significant difference in 30-day mortality, unplanned readmission, and other complications between the thoracoscopic and open groups. Thoracoscopic approach was associated with a shorter length of stay. The proportion of cases approached via thoracoscopy increased over time from 48.8% in 2013 to 69.9% in 2020. Conclusions: This large multicenter retrospective matched analysis demonstrates thoracoscopic lobectomy in children has similar favorable 30-day outcomes and shorter length of stay for the non-emergent management of CLM, compared to open thoracotomy. Level of evidence: Level III.

Original languageEnglish
Article number155
JournalPediatric Surgery International
Volume39
Issue number1
DOIs
Publication statusPublished - Dec 2023
Externally publishedYes

Keywords

  • CLM
  • CPAM
  • Minimally invasive surgery
  • Pediatric
  • Video-assisted thoracoscopic surgery

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