title: Thoracoscopic segmentectomy for treatment of congenital lung malformations.
abstract: OBJECTIVE
  Congenital lung malformations (CLM) predispose patients to recurrent respiratory tract infections and pose a rare risk of malignant transformation. Although pulmonary lobectomy is the most common treatment of a CLM, some advocate segmental resection as a lung preservation strategy. Our study evaluated lung-preserving thoracoscopic segmentectomy as an alternative to lobectomy for CLM resection.
  
  
  METHODS
  We conducted a retrospective review of patients who underwent thoracoscopic segmentectomy for CLM from 2007 to 2010.
  
  
  RESULTS
  Fifteen patients underwent thoracoscopic segmentectomy for CLM. There were five postoperative complications: three asymptomatic pneumothoraces and a small air leak that resolved without intervention. One patient developed a bronchopulmonary fistula requiring thoracoscopic repair. At follow-up, all patients are asymptomatic. One patient has a small amount of residual disease on postoperative computed tomography (CT), and re-resection has been recommended.
  
  
  CONCLUSIONS
  Thoracoscopic segmentectomy for CLM is a safe and effective means of lung parenchymal preservation. The approach spares larger airway anatomy and has a complication rate that is comparable with that of thoracoscopic lobectomy. Residual disease can often only be appreciated on postoperative CT scan and may require long-term follow-up or reoperation in rare cases. This lung preservation technique is best suited to smaller lesions.
authors.affiliation: Kapi'olani Medical Center for Women & Children, Honolulu, HI, USA. Sidney.Johnson@kapiolani.org
authors.forename: Sidney M
authors.initials: SM
authors.lastname: Johnson
authors.forename: Nalani
authors.initials: N
authors.lastname: Grace
authors.forename: Mary J
authors.initials: MJ
authors.lastname: Edwards
authors.forename: Russell
authors.initials: R
authors.lastname: Woo
authors.forename: Devin
authors.initials: D
authors.lastname: Puapong
mesh_terms: D000293:Adolescent; D001998:Bronchopulmonary Sequestration / Q000000981:diagnostic imaging / Q000601:surgery; D002675:Child, Preschool; D000013:Congenital Abnormalities / Q000601:surgery; D015615:Cystic Adenomatoid Malformation of Lung, Congenital / Q000000981:diagnostic imaging / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D008168:Lung / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D059351:Organ Sparing Treatments; D011013:Pneumonectomy / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013906:Thoracoscopy / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome