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Open vs thorascopic surgical management of bronchogenic cysts
C Tölg1, K Abelin, V Laudenbach
1Department of Pediatric Surgery, Hôpital Robert Debré, Paris, France.
Insights
Pediatric bronchogenic cyst resection via thoracoscopy offers shorter drainage and hospital stays compared to open surgery. Both methods are safe, but complete cyst wall excision is crucial for effective treatment.
Area of Science:
- Pediatric Surgery
- Thoracic Surgery
- Surgical Outcomes
Background:
- Bronchogenic cysts are congenital lung malformations requiring surgical intervention.
- Comparing open and thoracoscopic resection is essential for optimizing pediatric care.
Purpose of the Study:
- To compare the operative outcomes of open versus thoracoscopic resection of bronchogenic cysts in children.
- To evaluate key metrics including hospital stay, drainage duration, and complication rates.
Main Methods:
- Retrospective review of medical records for children undergoing bronchogenic cyst resection between 1990-2000.
- Analysis of data from 4 open procedures and 5 thoracoscopic procedures.
- Investigation of patient age, hospital stay, drainage duration, operating time, and outcomes.
Main Results:
- Thoracoscopic patients were older (7.8 vs 3.25 years) and had significantly shorter drainage (2.5 vs 6.5 days) and hospital stays (6 vs 12 days).
- Operating times were similar, barring one thoracoscopic conversion to open surgery (320 min).
- No deaths occurred; complication rates were comparable, with one reoperation for incomplete excision in each group.
Conclusions:
- Bronchogenic cyst resection is safe in children, with complete excision being key.
- Thoracoscopic resection can reduce drainage duration and hospital stay without increasing operative time or complications.
- This minimally invasive approach is a viable option for selected pediatric patients.
Background:
The aim of this study was to compare the operative outcome in children undergoing open vs thoracoscopic resection of bronchogenic cysts.
Methods:
The medical records of children who underwent the resection of bronchogenic cysts from 1990 through 2000 were reviewed. Four cyst resections were performed by the open technique and five using a thoracoscopic procedure. The age of the patients, length of hospital stay, duration of drainage, operating time, and outcome were investigated.
Results:
The mean age of patients undergoing the open procedure was 3 years and 3 months; the mean age for thoracoscopy patients was 7 years and 10 months (p < 0.05). The operating time for the open procedure was 70 +/- 25 min; for the laparoscopic procedure, it was 78 +/- 6 min (p, NS), except in one case with a main bronchial tail that required conversion (320 min). Duration of surgical drainage was 6.5 +/- 3 days for the open procedure and 2.5 +/- 1 days for the thoracoscopic one (p < 0.05). Hospital stay for open patients was 12 days +/- 0 days; it was 6 +/- 1.6 days for thoracoscopic patients (p < 0.01). There were no deaths. The thoracoscopic procedure failed once due to a main bronchial tail and had to be converted to an open procedure. Other early complications included a bronchopulmonary infection after an open cyst excision and an atelectasis after a thoracoscopic cyst excision. Late complications included one reoperation for incomplete excision in each of the two groups.
Conclusion:
Bronchogenic cyst resection can be performed safely. For complete treatment of these patients, total excision of the wall cyst is needed. In selected patients, the thoracoscopic procedure may decrease the duration of surgical drainage and length of hospital stay without increasing the operating time or MSK for complications.
