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Medium-Term Pulmonary Function Test After Thoracoscopic Lobectomy and Segmentectomy for Congenital Lung Malformation:
Jin-Xi Huang1,2,3,4, Song-Ming Hong1,2,3,4, Jun-Jie Hong1,2,3,4
1Department of Cardiothoracic Surgery, Fujian Branch of Shanghai Children's Medical Center, Fuzhou, China.
Insights
Thoracoscopic segmentectomy offers better short-term pulmonary function recovery than lobectomy in infants with congenital lung malformation. Lung function normalizes for both procedures within two years.
Area of Science:
- Pediatric Surgery
- Thoracic Surgery
- Pulmonary Medicine
Background:
- Congenital lung malformations (CLMs) are a significant cause of respiratory distress in infants.
- Surgical management of CLMs often involves either segmentectomy or lobectomy.
- Understanding the long-term pulmonary function outcomes after these procedures is crucial for patient management.
Purpose of the Study:
- To compare the short-term and medium-term pulmonary function test (PFT) outcomes between thoracoscopic segmentectomy and lobectomy in infants with CLMs.
- To evaluate the overall surgical outcomes, including hospital stay and drainage, for both procedures.
Main Methods:
- Retrospective study of 19 infants undergoing thoracoscopic segmentectomy for CLMs.
- Propensity score matching used to compare with 19 infants undergoing thoracoscopic lobectomy.
- Postoperative PFTs at 1 month and 2 years, with age-matched healthy individuals as controls.
Main Results:
- No significant difference in hospital stay length between segmentectomy and lobectomy groups.
- Segmentectomy group experienced more chest tube drainage.
- Lobectomy group showed lower tidal volume and signs of small airway dysfunction at 1 month post-op; these resolved by 2 years, with no significant PFT differences among groups.
Conclusions:
- Thoracoscopic segmentectomy demonstrates superior short-term pulmonary function recovery compared to lobectomy in infants with CLMs.
- Both thoracoscopic lobectomy and segmentectomy result in normal lung function at the 2-year follow-up.
Abstract:
Purpose: This study aimed to compare the outcomes and pulmonary function test (PFT) of thoracoscopic segmentectomy and lobectomy in infants with congenital lung malformation and study the result of PFT on a medium-term basis. Methods: The clinical data of 19 infants with congenital lung malformation who underwent thoracoscopic surgery in our hospital from January 2018 to March 2019 were retrospectively studied; these infants were paired with another 19 infants who underwent thoracoscopic lobectomy during the same period using propensity score matching. Age-matched healthy individuals with similar body sizes were recruited for PFT as the control group. Patient characteristics, postoperative PFT, and outcomes were extracted for statistical analysis. Results: The average length of hospital stay did not significantly differ between segmentectomy and lobectomy groups. The segmentectomy group had more chest tube drainage than the lobectomy group. PFT 1 month after the operation showed that the tidal volume of the lobectomy group was lower than that of the segmentectomy group. Time to peak expiratory flow/time of expiration and peak flow/terminal airway velocity (V25%) indicated small airway dysfunction in the lobectomy group, and no obvious abnormalities were found in "time of inspiratory/time of expiration" in either group. Reexamination of pulmonary function 2 years after the operation showed that the small airway function of the segmentectomy group returned to normal, and no significant difference in pulmonary function was noted among the three groups. Conclusion: The short-term pulmonary function recovery was better after segmentectomy than after lobectomy. Patients who underwent thoracoscopic lobectomy and segmentectomy have normal lung function 2 years after the operation.
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