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Morbidity after thoracoscopic resection of congenital pulmonary airway malformations (CPAM): single center experience

Hadiya Khan1, Meera Kurup2, Sanjay Saikia2

  • 1Royal Surrey County Hospital, Guildford, GU2 7XX, UK.

Pediatric Surgery International
|January 3, 2021
PubMed

Insights

Video-assisted thoracoscopic surgery (VATS) for congenital pulmonary airway malformation (CPAM) in children shows potential risks outweighing benefits in asymptomatic cases. Post-operative symptoms persisted in many children, regardless of surgical intervention.

Area of Science:

  • Pediatric Surgery
  • Thoracic Surgery
  • Congenital Malformations

Background:

  • Congenital Pulmonary Airway Malformation (CPAM) is a congenital lung lesion in infants and children.
  • Video-assisted thoracoscopic surgery (VATS) is a minimally invasive approach for CPAM resection, but its efficacy and safety remain debated.
  • This study evaluates a 10-year single-center experience with VATS for CPAM in pediatric patients.

Purpose of the Study:

  • To assess the outcomes of VATS resection for CPAM in children.
  • To compare outcomes between symptomatic and asymptomatic children undergoing VATS for CPAM.
  • To evaluate the impact of VATS on post-operative respiratory symptoms in children with CPAM.

Main Methods:

  • A retrospective review of 73 children who underwent VATS for CPAM between 2008 and 2017.
  • Patients were categorized into 'symptomatic-P' (recurrent respiratory infections), 'symptomatic-S' (neonatal respiratory distress), or 'asymptomatic' groups.
  • Surgical outcomes, complications (Clavien-Dindo classification), and post-operative symptom status were analyzed.

Main Results:

  • 73 children underwent VATS for CPAM; 7 (10%) required conversion to open thoracotomy.
  • Post-operative complications occurred in 8 children (11%), including persistent air leak and pneumothorax.
  • A significant proportion of children (33.3%) remained symptomatic post-surgery, with no significant impact from the intervention.

Conclusions:

  • The risks associated with VATS for CPAM may exceed the benefits in asymptomatic children.
  • Surgical intervention did not significantly improve the symptomatic status in children with CPAM.
  • Further investigation is warranted to optimize management strategies for pediatric CPAM.
Abstract

Keywords:
ChildrenComplicationsCongenital pulmonary airway malformationsInfantsOutcomesThoracic surgery video-assisted

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