Comparison between segmentectomy and lobectomy for treating congenital lung malformation: A NSQIP database study

Area of Science:

• Pediatric surgery
• Thoracic surgery
• Congenital lung malformations

Background:

• Congenital pulmonary airway malformation (CPAM) and bronchopulmonary sequestration (BPS) diagnoses are increasing due to improved prenatal imaging.
• Thoracoscopic lobectomy is standard, but segmentectomy is gaining favor for lung tissue preservation.
• This study compares thoracoscopic lobectomy and segmentectomy in pediatric patients.

Purpose of the Study:

• To compare the operative time, hospital stay, and short-term complications of thoracoscopic lobectomy versus segmentectomy in pediatric patients with CPAM or BPS.
• To evaluate the safety and efficacy of segmentectomy as an alternative to lobectomy.

Main Methods:

• Utilized the National Surgical Quality Improvement Program Pediatric (NSQIP-P) database from 2015-2023.
• Included patients under 19 with CPAM or BPS undergoing thoracoscopic lobectomy or segmentectomy.
• Compared outcomes including operative time, length of stay, and 30-day complications using 1:1 propensity matching.

Main Results:

• Matched analysis of 84 patients per group showed segmentectomy had significantly shorter operative time (117.6 vs. 185.4 minutes) and hospital stay (2.00 vs. 2.65 days).
• Surgical time alone was not significantly different between the two procedures.
• No meaningful differences were observed in complications, reoperations, readmissions, or transfusion rates; no deaths occurred.

Conclusions:

• Segmentectomy provides significant short-term advantages in operative and recovery times compared to lobectomy for pediatric CPAM and BPS.
• The procedure appears safe, with no increased risk of complications in the short term.
• Longer follow-up is necessary to assess long-term lung function and recurrence rates.