Indications, Trends and Outcomes in Pediatric Lung Resections: A 12-Year Study in a Tertiary Referral Center

Area of Science:

• Pediatric Surgery
• Thoracic Surgery
• Pulmonology

Background:

• Pediatric lung resections are uncommon but essential for congenital lung malformations (CLMs) and acquired lung diseases.
• Limited research exists on the full spectrum of indications, complications, and outcomes for pediatric lung resections.
• This study analyzes a decade of data from a tertiary pediatric center to address this knowledge gap.

Purpose of the Study:

• To evaluate the indications, surgical approaches, complications, and outcomes of lung resections in children.
• To compare outcomes between congenital lung malformations (CLMs) and acquired pathologies.
• To assess temporal trends in surgical approaches and their impact on patient outcomes.

Main Methods:

• Retrospective analysis of 160 pediatric patients undergoing lung resection between 2012 and 2024.
• Data collected included indications, surgical approach (thoracoscopy vs. thoracotomy), complications, and outcomes.
• Statistical comparisons were made between pathologies, approaches, and temporal trends.

Main Results:

• Acquired lesions (68.6%) were more frequent than CLMs (31.4%), particularly in children under 8.
• Thoracoscopy, used in 72.8% of cases, was associated with shorter operative times and hospital stays compared to thoracotomy.
• The overall complication rate was 19.5%, with CLMs showing fewer complications (14.3%) and better outcomes (89.2%) than acquired lesions (23.1% complications, 64.7% outcomes).
• Thoracoscopy use increased over time, with reduced operative times, while complication and outcome rates remained stable.

Conclusions:

• Pediatric lung resections effectively treat diverse lung pathologies, with outcomes significantly influenced by the underlying condition.
• Congenital lung malformations are associated with lower complication rates and more favorable outcomes compared to acquired lesions.
• Thoracoscopy has become the preferred minimally invasive approach, offering benefits in postoperative recovery, contingent on careful patient selection based on pathology.