title: Muscle-sparing thoracotomy combined with mechanically stapled lung resection for benign lung disorders: functional results and quality of life.
abstract: We set out to review our experience with resection of benign lung lesions performed using mechanical stapling devices via a muscle-sparing thoracotomy, and provide data on long-term morbidity, functional results, and quality of life (QOL). Fifty-two patients with a benign lung disorder were included in the study. All underwent a lung resection with mechanical staplers via a muscle-sparing thoracotomy. Medical records were retrospectively searched for postoperative complications. Nineteen patients (36.5%) also underwent a final follow-up including clinical examination, radiological investigations, functional tests, and assessment of QOL by a standardized questionnaire. No intra-operative complications occurred. The resection was anatomical (lobectomy) in 28 (53%) children and wedge in 25 (47%). Five cases (9.6%) required secondary surgery. Of the 19 children undergoing long-term follow-up, 3 (16%) had musculoskeletal anomalies and 6 (31.5%) respiratory symptoms. All X-rays were normal. Spirometry was abnormal in 9 cases (47.3%). QOL was excellent/good in 17 cases (89.5%) and sufficient in 2 (10.5%). An abnormal spirometric pattern was significantly more frequent in cases with a poorer QOL. In conclusion, stapled resection via a muscle-sparing thoracotomy is a good option to perform lung resections. However, a muscle-sparing approach does not avoid entirely long-term musculoskeletal complications. QOL is good in nearly 90% of cases, but respiratory symptoms and abnormal spirometric function can be found in one third and half of the patients, respectively. An abnormal spirometry is more common in patients with a poorer QOL. Systematic radiological follow-up is unnecessary.
authors.affiliation: Department of Paediatric Surgery, Giannina Gaslini Children's Hospital and Research Institute, University of Genova, Largo G. Gaslini, 5, 16147, Genova, Italy.
authors.forename: Girolamo
authors.initials: G
authors.lastname: Mattioli
authors.forename: Caterina
authors.initials: C
authors.lastname: Asquasciati
authors.forename: Marco
authors.initials: M
authors.lastname: Castagnetti
authors.forename: Simona
authors.initials: S
authors.lastname: Bellodi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Rossi
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Jasonni
mesh_terms: D000293:Adolescent; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008171:Lung Diseases / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications; D011788:Quality of Life; D012189:Retrospective Studies; D013147:Spirometry; D018709:Statistics, Nonparametric; D017792:Surgical Stapling; D011795:Surveys and Questionnaires; D013908:Thoracotomy / Q000379:methods*; D016896:Treatment Outcome