Thoracoscopic versus open resection of congenital lung lesions: a case-matched study.
OBJECTIVE
The purpose of the study was to compare the outcomes in children undergoing thoracoscopic versus open resection of congenital lung lesions.


METHODS
Retrospective review of 12 consecutive children (<3 years of age) undergoing thoracoscopic resection of a congenital lung lesion between 2004 and 2005 was performed. Intraoperative and early postoperative results were compared with randomly selected age- and sex-matched (2:1) patients undergoing thoracotomy between 2000 and 2005.


RESULTS
Twelve children underwent thoracoscopic resection and were compared with 24 that underwent thoracotomy. Seventy five percent of the lesions in both groups were congenital cystic adenomatoid malformations. There were no major intraoperative complications. Two thoracoscopic procedures were converted to a thoracotomy. Perioperative outcomes including operative time, length of stay, duration and volume of chest tube drainage, and dose and duration of intravenous opioids were similar for the procedures. However, children undergoing thoracoscopic procedures were less likely (odds ratio = 0.07) to have received adjunctive regional anesthesia. Overall morbidity was 33% thoracoscopic and 25% open (P = .70).


CONCLUSIONS
Thoracoscopic resection is a safe and feasible alternative to open resection of congenital lung lesions. Examination of long-term advantages of the thoracoscopic approach such as decreased risk of chest wall deformity and scoliosis and improved cosmesis will require longer follow-up.
Diamond
Ivan R
IR
Division of General Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada M5G 1X8.
Herrera
Patricio
P
Langer
Jacob C
JC
Kim
Peter C W
PC
D016022:Case-Control Studies; D015505:Chest Tubes / Q000706:statistics & numerical data; D000013:Congenital Abnormalities / Q000601:surgery; D015615:Cystic Adenomatoid Malformation of Lung, Congenital / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay / Q000706:statistics & numerical data; D008168:Lung / Q000002:abnormalities*; D008297:Male; D009294:Narcotics / Q000627:therapeutic use; D010149:Postoperative Pain / Q000188:drug therapy / Q000453:epidemiology; D011013:Pneumonectomy / Q000379:methods* / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013906:Thoracoscopy / Q000706:statistics & numerical data*; D013908:Thoracotomy / Q000706:statistics & numerical data*; D016896:Treatment Outcome
D009294:Narcotics