title: Thoracoscopic resection of congenital cystic lung lesions is associated with better post-operative outcomes.
abstract: BACKGROUND
  The incidence of congenital cystic lung lesions has been increasing in recent years due to better antenatal detection. With the introduction and maturation of thoracoscopy, the operative management for these lesions has seen advancement in the last decade. In this study, we aimed to compare the post-operative outcomes of patients who had thoracoscopic resection with those who underwent open resection.
  
  
  METHODS
  A retrospective review of all patients who underwent surgery for congenital cystic lung lesions between January 1996 and June 2012 in a tertiary referral center was conducted. Patients' demographics, operative procedures and post-operative outcomes were analyzed.
  
  
  RESULTS
  Sixty-seven patients were identified over the past 15 years. Thirty-nine patients had thoracoscopic resections and 28 had open resections. Thirteen patients in the thoracoscopic group required conversion. Both groups had similar demographics in terms of age, body weight and laterality of lesions. The mean operative time and blood loss in the two groups were comparable. Patients in the thoracoscopic group had significantly shorter duration of chest tube drainage (4.3 vs. 6.9 days, p = 0.004), shorter intensive care unit stay (2.5 vs. 5.9 days, p = 0.003) and shorter hospital stay (6.9 vs. 12.0 days, p < 0.001). Post-operative complication rate was similar between the two groups. Patients with body weight less than 5 kg showed a significantly higher conversion to open surgery as compared to those with body weight more than 5 kg (62.5 vs. 25.8 %, p = 0.049).
  
  
  CONCLUSIONS
  Successful thoracoscopic resection for congenital cystic lung lesions results in better post-operative outcomes. However, this technique remains technically challenging in patients with body weight less than 5 kg.
authors.affiliation: Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Pokfulam Road, Hong Kong SAR, China.
authors.forename: C T
authors.initials: CT
authors.lastname: Lau
authors.forename: L
authors.initials: L
authors.lastname: Leung
authors.forename: I H Y
authors.initials: IH
authors.lastname: Chan
authors.forename: P H Y
authors.initials: PH
authors.lastname: Chung
authors.forename: L C L
authors.initials: LC
authors.lastname: Lan
authors.forename: K L
authors.initials: KL
authors.lastname: Chan
authors.forename: K K Y
authors.initials: KK
authors.lastname: Wong
authors.forename: P K H
authors.initials: PK
authors.lastname: Tam
mesh_terms: D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D001994:Bronchogenic Cyst / Q000601:surgery; D001998:Bronchopulmonary Sequestration / Q000601:surgery; D002675:Child, Preschool; D061887:Conversion to Open Surgery / Q000706:statistics & numerical data; D015615:Cystic Adenomatoid Malformation of Lung, Congenital / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D008171:Lung Diseases / Q000151:congenital* / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D011656:Pulmonary Emphysema / Q000151:congenital / Q000601:surgery; D012189:Retrospective Studies; D013906:Thoracoscopy / Q000009:adverse effects; D016896:Treatment Outcome