Segmental resection for the treatment of congenital pulmonary malformations
Segmental resection for the treatment of congenital pulmonary malformations
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DOI：
10.1016/j.jpedsurg.2014.01.021
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发表时间：
2014-06-01
影响因子：
2.4
通讯作者：
Shilyansky, Joel
中科院分区：
文献类型：
--
作者：
Bagrodia, Naina;Cassel, Shannon;Shilyansky, Joel
目的：本研究的目的是比较节段性肺切除与肺叶切除术的临床结果，因为先天性肺畸形的产前诊断越来越多，导致了手术治疗的转变。方法：对接受手术切除的先天性肺畸形患者进行回顾性分析。结果：对2001 ~ 2012年62例先天性肺畸形患者进行回顾性分析。其中45例纳入分析。畸形再分为两组，先天性肺气肿（CLE） （n = 11, 24%）和肺内（IP）病变（n = 34, 76%）。19例（56%）IP患者行节段性切除，15例（79%）行胸腔镜手术，未转开胸。这些患者均无复发性疾病。11例（100%）CLE患者行肺叶切除术，15例（44%）IP患者行肺叶切除术，多数采用开胸术。肺叶切除术组的中位住院时间为7天，而节段切除术组的中位住院时间为2天（p < 0.001）。节段切除术与肺叶切除术患者的并发症发生率（21% vs. 19%, p = 1.000）和中位胸管天数（2 vs. 3天，p = 0.079）均无差异。结论：在保留健康肺组织的前提下，对先天性肺畸形进行节段性切除是安全可行的。(C) 2014爱思唯尔公司版权所有。
Purpose: The purpose of this study was to compare clinical outcomes of segmental resection to lobectomy as increasing antenatal diagnosis of congenital pulmonary malformations has led to a shift in surgical management.Methods: A retrospective institutional review for patients undergoing surgical excision of congenital pulmonary malformations was performed.Results: Sixty-two patients with congenital pulmonary malformations were reviewed between 2001 and 2012. Forty-five were included for analysis. Malformations were subdivided into two groups, including congenital lobar emphysema (CLE) (n = 11, 24%) and intrapulmonary (IP) lesions (n = 34, 76%). Nineteen (56%) IP patients underwent segmental resection, and 15 (79%) were performed thoracoscopically without conversion to thoracotomy. None of these patients had recurrent disease. Lobectomy was performed in 11 (100%) CLE and 15 (44%) IP patients, and the majority were by thoracotomy. Median hospital stay was longer for the lobectomy group at 7 days when compared to the segmentectomy group at 2 days (p < 0.001). There was not a difference in complication rate (21% vs. 19%, p = 1.000) or in median number of chest tube days (2 vs. 3 days, p = 0.079) for segmentectomy versus lobectomy patients.Conclusions: Segmental resections of congenital pulmonary malformations can be performed safely while conserving healthy lung tissue. (C) 2014 Elsevier Inc. All rights reserved.