Thoracoscopic Lobectomy for Congenital Pulmonary Airway Malformation with Prenatal Diagnosis
Date of submission: 03-05-2020 | Date of acceptance: 16-09-2020 | Published: 03-01-2021
INTRODUCTION: Congenital pulmonary airway malformations (CPAM) are increasingly diagnosed in the prenatal period raising concerns on the post-natal management of asymptomatic cases. Favoring early resection are the concepts of better compensatory lung growth, and prevention of long-term risk of infection and malignancy. Our aim was to review the results of our conduct over the years, in which we promote early thoracoscopic resection.
METHODS: We have analyzed the series of patients with congenital pulmonary malformations submitted to thoracoscopic resection at our department, focusing on the infants with prenatal diagnosis of CPAM.
RESULTS: From March 2012 to March 2020, we have performed 24 thoracoscopic pulmonary resections at our department for CPAM, congenital lobar emphysema, pulmonary sequestration, bronchogenic cyst and pleuropulmonary blastoma. Among these, nineteen performed thoracoscopic pulmonary lobectomy, including 14 children with prenatal diagnosis of CPAM that were operated during infancy. In our series of thoracoscopic pulmonary lobectomy, we did not have any perioperative complication. Regarding post-operative complications, we have to report two cases treated conservatively, but none in the subgroup of CPAM with prenatal diagnosis. Median length of stay was three days. In the entire series two patients report recurrent wheezing, whilst in the prenatal diagnosed CPAM subgroup all patients have a completely uneventful follow-up.
CONCLUSION: Early thoracoscopic resection of prenatal diagnosed CPAM is safe and should be considered in cases with significant lung (morphological) malformation as the esthetic and clinical outcomes are excellent.
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