Clinical efficacy of thoracoscopy versus traditional thoracotomy in treatment of congenital pulmonary sequestration in children

Abstract

Objective To compare the clinical efficacy between thoracoscopic surgery and traditional thoracotomy in the treatment for children with congenital pulmonary sequestration (PS), and investigate the value of thoracoscopic surgery for PS. Methods The clinical data of 41 children diagnosed with congenital PS and surgically treated in our hospital from January 2015 to January 2020 were collected and retrospectively analyzed. The choice of clinical surgical methods was determined by the inclusion criteria for patients of the 2 groups respectively. According to the received surgical methods, these children were assigned into thoracotomy group (n=20, 12 males and 8 females, 86.07±38.96 months, ranging from 3 d to 12 years and 8 months old) and thoracoscopy group (n=21, 11 males and 10 females, 99.06±57.38 months, ranging from 4 months to 11 years and 2 months old). All of them were followed up for 5 months to 5 years. The operation time, intraoperative blood loss, chest drainage time, postoperative hospital stay and other surgical indicators were compared and analyzed between the 2 groups, so were the mortality, incidence of complications and recurrence. Results Both groups were successfully completed the surgery with no death or serious complications. There were no significant differences in age, weight and sites of disease between the 2 groups (P>0.05), and 1 case in the thoracoscopy group was converted to thoracotomy during operation due to severe pleural adhesion. The intraoperative blood loss, and times for postoperative mechanical ventilation, chest drainage tube indwelling, retention in coronary care unit (CCU) and hospital stay in the thoracoscopy group were statistically better than those in the thoracotomy group (P < 0.05). However, the operation time in the thoracoscopy group was obviously longer than that in the thoracotomy group (P < 0.05). Conclusion Both thoracoscopic surgery and thoracotomy can effectively treat congenital PS in children. Compared with thoracotomy, thoracoscopy has less trauma, faster recovery and fewer complications.

Keywords

• pulmonary sequestration
• thoracoscopic surgery
• traditional thoracotomy
• lobectomy
• child