Long-term Outcomes of Children Undergoing Thoracotomy Lung Resection for Congenital Lung Malformations

Area of Science:

• Pediatric Surgery
• Thoracic Surgery
• Pulmonology

Background:

• Congenital lung malformations (CLMs) are a significant cause of respiratory issues in children.
• Surgical resection via thoracotomy is a common treatment for CLMs.
• Long-term outcomes following pediatric thoracotomy for CLMs require further investigation.

Purpose of the Study:

• To evaluate the long-term lung function, complication rates, and health-related quality of life (HRQOL) in children after thoracotomy for CLMs.
• To assess the persistence of pulmonary and musculoskeletal morbidities post-surgery.
• To compare outcomes with healthy controls.

Main Methods:

• Retrospective review of 27 children undergoing thoracotomy for CLMs (1992-2017) with >5 years follow-up.
• Postoperative lung function tests (percent predicted vital capacity [%VC], percent predicted forced expiratory volume in 1 second [%FEV1], FEV1/FVC ratio) were analyzed.
• Pediatric Quality of Life Inventory (PQLI) was used to assess HRQOL and morbidities.

Main Results:

• Lung function (%VC and FEV1/FVC) was significantly lower than controls, with %FEV1 below normal range, showing no significant longitudinal changes.
• Asthma-like symptoms affected 37.0% of patients, persisting into adolescence; musculoskeletal morbidities occurred in 33.3%, including 5 pectus excavatum cases.
• Health-related quality of life (HRQOL) did not differ significantly from healthy controls.

Conclusions:

• Children undergoing thoracotomy for CLMs experience persistent, significantly reduced lung function compared to healthy peers.
• Despite long-term pulmonary and musculoskeletal complications, subjective HRQOL is not adversely affected.
• These findings highlight the need for long-term monitoring and management of respiratory and musculoskeletal health in this patient population.