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Published on: June 23, 2023
Effect analysis of flexible bronchoscopy in thoracoscopic surgery for congenital pulmonary airway malformation
Zhenlei Jia1, Yun Li, Xiaoyan Liu
1Department of Thoracic Surgery, Hebei Provincial Children's Hospital, Shijiazhuang, Hebei Province, China.
Insights
Flexible bronchoscopy (FB) significantly reduces postoperative complications like atelectasis in pediatric patients undergoing thoracoscopic surgery for congenital pulmonary airway malformation (CPAM). This effective technique also lowers inflammation, drainage, and hospital stays.
Area of Science:
- Pediatric Surgery
- Pulmonology
- Thoracic Surgery
Background:
- Congenital pulmonary airway malformation (CPAM) is a significant condition in pediatric patients.
- Thoracoscopic surgery is a common treatment for CPAM.
- The role of flexible bronchoscopy (FB) in conjunction with thoracoscopic surgery for CPAM requires further investigation.
Purpose of the Study:
- To investigate the clinical efficacy of flexible bronchoscopy (FB) in pediatric patients undergoing thoracoscopic surgery for congenital pulmonary airway malformation (CPAM).
Main Methods:
- A randomized controlled trial comparing FB with conventional thoracoscopic surgery in 45 pediatric CPAM patients.
- Patients were divided into two groups: Group A (24 patients) received FB, and Group B (21 patients) underwent conventional thoracoscopic surgery.
- Clinical data, including postoperative complications and recovery metrics, were analyzed over a minimum 3-month follow-up period.
Main Results:
- The postoperative atelectasis rate was significantly lower in the FB group (0%) compared to the conventional group (28.6%) (P=.018).
- Flexible bronchoscopy group showed significantly reduced chest drainage time, total drainage volume, postoperative inflammatory markers, and hospitalization time (P<.05 for all).
- No significant differences were observed in other complications, gender, age, prenatal diagnosis, surgical methods, operation time, blood loss, or ventilator use.
Conclusions:
- Flexible bronchoscopy is an effective and feasible adjunct to thoracoscopic surgery for pediatric CPAM.
- FB application can alleviate postoperative inflammatory reactions, decrease drainage, shorten hospital stays, and prevent atelectasis.
- FB demonstrates significant benefits in improving patient recovery after CPAM surgery.
Abstract:
The objective of this study is to investigate the clinical efficacy of flexible bronchoscopy (FB) in thoracoscopic surgery for congenital pulmonary airway malformation (CPAM) in pediatric patients. We randomly divided the CPAM patients who underwent thoracoscopic surgery at our hospital from May 2022 to January 2024 into 2 groups based on whether they received FB treatment before and after thoracoscopic surgery. Group A included 24 patients who received FB treatment, while Group B consisted of 21 patients who underwent conventional thoracoscopic surgery. We performed a comparative analysis of the clinical data between the 2 groups. All patients successfully underwent thoracoscopic surgery and were followed up for at least 3 months. The postoperative atelectasis rate in Group A (0%) was significantly lower than that in Group B (28.6%), with a statistically significant difference (P = .018). There was no statistically significant difference in other postoperative complications, and no severe postoperative complications occurred in either group. The chest drainage time, total drainage volume, postoperative inflammatory markers, and postoperative hospitalization time in Group A were all significantly lower than those in Group B (P = .000, P = .014, P = .001, P = .022, P = .006, P = .001). No significant differences were observed in gender, age, or prenatal diagnosis rate between the 2 groups. Additionally, there were no significant differences in surgical methods, operation time, intraoperative blood loss, or postoperative ventilator use between the 2 groups. The application of FB in thoracoscopic surgery for CPAM is both effective and feasible. It can effectively alleviate postoperative inflammatory reactions, reduce drainage volume, shorten postoperative hospital stays, and prevent postoperative atelectasis.
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