Comparing 30-day outcomes between thoracoscopic and open approaches for resection of pediatric congenital lung malformations: Evidence from NSQIP

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Abstract

Background/Purpose: Thoracoscopic surgery has been increasingly utilized in treating pediatric congenital lung malformations (CLM). Comparative studies evaluating 30-day outcomes between thoracoscopic and open resection of CLM are lacking. Methods: There were 258 patients identified in pediatric NSQIP with a CLM and pulmonary resection in 2012–2013. Comparisons of patient characteristics and outcomes between surgical approaches were made using standard univariate statistics. In addition, a propensity score match was performed to evaluate outcomes in similar patient cohorts. Results: One-hundred twelve patients (43.4%) received thoracoscopic resections and 146 patients (56.6%) received open resections. Patients undergoing open resections were more likely to be less than 5 months of age and have a comorbidity/preoperative condition (47.3% vs. 25.0%, p < 0.001). The extent of resection was a lobectomy in 84.8% of thoracoscopic and 92.5% of open resection patients. Median operative time was similar between both groups (thoracoscopic 172 vs. open 153.5 minutes). On univariate analysis, thoracoscopic resection was associated with decreased postoperative complications (9.8% vs. 25.3%, p = 0.001) and LOS (3 vs. 4 days, p < 0.001). However, after adjusting for similar patient and operative characteristics, no significant differences were encountered between techniques. Conclusions: Thoracoscopic and open resection provide comparable 30-day outcomes and safety in the management of congenital lung malformations.

Original languageEnglish (US)
Pages (from-to)1716-1721
Number of pages6
JournalJournal of pediatric surgery
Volume50
Issue number10
DOIs
StatePublished - Oct 2015

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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