Thoracoscopic surgery for congenital lung cysts: an attempt to limit pulmonary resection in cases of lesions involving multiple lobes

• Published in: Pediatric surgery international Vol. 37; no. 2; pp. 213 - 221
• Main Authors: Shirota, Chiyoe, Tainaka, Takahisa, Sumida, Wataru, Yokota, Kazuki, Makita, Satoshi, Takimoto, Aitaro, Amano, Hizuru, Hinoki, Akinari, Ono, Yasuyuki, Uchida, Hiroo
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-02-2021; Springer Nature B.V
• Subjects: Cameras; Cysts; Lungs; Medicine; Medicine & Public Health; Original Article; Ostomy; Patients; Pediatric Surgery; Pediatrics; Pneumonectomy; Pneumothorax; Surgery; Navigation surgery; Segmentectomy; Congenital lung cysts; Child; Thoracoscopic surgery
• ISSN: 0179-0358; 1437-9813
• DOI: 10.1007/s00383-020-04793-y

Purpose
Although we generally perform thoracoscopic lobectomy for congenital lung cysts (CLCs), we recently began performing thoracoscopic-limited pulmonary resection (segmentectomy or small partial lung resection) on relatively small lesions and on lesions involving multiple lobes. Our study aimed to determine the therapeutic outcomes of thoracoscopic CLC surgery.
Methods
We retrospectively reviewed patients aged ≤ 18 years who underwent their first CLC surgery at our facility between 2013 and 2020.
Results
A comparison between patients < 4 months old and those ≥ 4 months old showed no significant difference in operating time or incidence of complications. Blood loss volume (mL/kg) was significantly greater in patients < 4 months old and in patients who had undergone semi-urgent or urgent surgery. Operating time and postoperative complications were not increased in semi-urgent or urgent surgeries. There was no significant difference in operating time, blood loss volume, or postoperative complications between patients with a preoperative history of pneumonia and patients with no such history.
Conclusion
In most patients, thoracoscopic surgery for CLC was safely performed. Limited pulmonary resection is considered difficult to perform thoracoscopically in children, but can be safely performed using new devices and navigation methods.
Level of evidence
III.