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Thoracoscopic Lobectomy for Congenital Lung Malformation in Children: Evolving Management Strategies and Their Impact

María López-Diaz1, Indalecio Cano Novillo2, Rocío Morante-Valverde1

  • 1Pediatric Airway Unit & Division of Pediatric Surgery, University Hospital 12 de Octubre, Madrid, Spain.

Journal of Pediatric Surgery
|October 23, 2024
PubMed

Insights

Thoracoscopic lobectomy in children can lead to complications, but new surgical techniques and devices are improving safety. Using specific sealing and section devices significantly reduced complication rates in pediatric patients.

Area of Science:

  • Pediatric Surgery
  • Thoracic Surgery
  • Surgical Innovation

Background:

  • Thoracoscopic lobectomy is a complex procedure in pediatric patients.
  • Assessing complication incidence and management strategies is crucial for improving outcomes.

Purpose of the Study:

  • To determine the incidence of complications after pediatric thoracoscopic lobectomy using the Clavien-Dindo classification.
  • To evaluate modifications in management protocols aimed at reducing complication rates.

Main Methods:

  • Retrospective analysis of 90 thoracoscopic lobectomies for congenital lung malformation (CLM) in pediatric patients (2003-2021).
  • Data collected included demographics, symptoms, surgical details, and postoperative complications (Clavien-Dindo classification).
  • Main outcome was the presence of complications within the first month post-surgery.

Main Results:

  • 28.8% of patients experienced postsurgical complications.
  • Bronchial stump closure with interrupted suture or endoloop was significantly associated with higher complication rates (p=0.022, p=0.006).
  • Utilizing a combined sealing and section device significantly reduced complications (p=0.006).

Conclusions:

  • Thoracoscopic lobectomy remains challenging, but the Clavien-Dindo system aids in complication assessment.
  • Advancements in surgical strategies and miniaturized devices enhance procedure safety and efficiency.
  • Evolving techniques positively impact the development of complications in pediatric thoracoscopic lobectomy.
Abstract

Keywords:
ChildrenCongenital lung malformationSurgical complicationsThoracoscopic lobectomy

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