Impact of pulmonary infection on thoracoscopic surgery outcomes in children with CPAM: a retrospective study

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Cui-Xia Yuan1, Chun Wu1, Zheng-Xia Pan1

  • 1Department of Cardiothoracic Surgery, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Diorders, Chongqing Key Laboratory of Structural Birth Defect and Reconstruction, Chongqing, China.

BMC Surgery
|March 11, 2025
PubMed

Insights

Pulmonary infection complicates surgical outcomes in children with congenital pulmonary airway malformation (CPAM). Early intervention before infection improves results and reduces risks associated with thoracoscopic surgery for CPAM.

Area of Science:

  • Pediatric Surgery
  • Thoracic Surgery
  • Pulmonology

Background:

  • Pulmonary infection is a frequent complication in pediatric congenital pulmonary airway malformation (CPAM).
  • Surgical intervention is a primary treatment for CPAM.
  • The impact of pulmonary infection on thoracoscopic surgery outcomes in CPAM requires further evaluation.

Purpose of the Study:

  • To assess how pulmonary infection affects outcomes of total thoracoscopic procedures in children with CPAM.
  • To compare surgical outcomes among children with CPAM based on infection status.

Main Methods:

  • A retrospective, single-center study of 154 children with CPAM undergoing thoracoscopic surgery (January 2013-December 2023).
  • Patients were classified into non-infection (NI), hidden infection (HI), and pulmonary infection (PI) groups.
  • Clinical characteristics and operative outcomes were compared across the three groups.

Main Results:

  • The conversion to thoracotomy rate was higher in the PI (29.2%) and HI (23.2%) groups compared to the NI group (14.8%).
  • Operative time and blood loss differed significantly across groups (p<0.05).
  • Pneumothorax incidence varied significantly among groups (p<0.05), unlike atelectasis or pneumonia.

Conclusions:

  • Pulmonary infection, including hidden infections, is common in CPAM and complicates thoracoscopic surgery.
  • Early thoracoscopic intervention before infection onset can optimize surgical outcomes and minimize complications in pediatric CPAM patients.
Abstract

Keywords:
ChildrenCongenital pulmonary airway malformationPulmonary infectionTotal thoracoscopic surgery

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