Surgical Treatment of Congenital Lung Malformations in Children
Abstract
Aim. To improve the outcomes of surgical treatment by developing new diagnostic approaches and introducing minimally invasive organ-preserving interventions in children with congenital lung malformations (CLM).
Materials and Methods. The study is based on the results of examination and treatment of 146 pediatric patients with CLM, aged from birth to 18 years, who underwent inpatient treatment between 2004 and 2024 at the clinics of TashPMI and the National Children’s Medical Center (NCMC). Clinical and instrumental methods were applied (X-ray, MSCT, bronchoscopy, echocardiography, angiography), bronchography to determine the volume of surgery, intraoperative visual assessment, and surgical treatment including resections and bronchial sealing with biopolymer.
Results. Surgical treatment of CLM in children (VATS lobectomy and bronchial sealing) yielded positive outcomes in 92.7% of patients. VATS lobectomy and sealing provided better functional results and fewer complications, with preserved ventilatory capacity.
Conclusion. Comprehensive diagnostics is essential for evaluating CLM. VATS lobectomy and bronchial sealing, as organ-preserving methods, are effective, reduce surgical trauma, hospitalization time, and the risk of disability.
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List of references
Ovsyannikov DY, Frolov PA, Semenov PA. Congenital malformation of the airways. Pediatriya. 2018;97(1):152–161. In Russian: Овсянников Д.Ю., Фролов П.А., Семенов П.А. Врожденная маль- формация дыхательных путей. Педиатрия. 2018;97(1):152–161.
Razumovskiy AY, et al. Minimally invasive surgery in the treatment of children with cystic adenomatoid malformation of the lungs. Detskaya Khirurgiya. 2013;(2):4–8. In Russian: Разумовский А.Ю. и др. Мини-инвазивная хирургия в лечении детей с кистозно-аденоматозной мальформацией легких. Детская хирургия. 2013;(2):4–8.
Tashilkina YuV, et al. Congenital cystic adenomatoid malformation of the lung type III: a clinical case. Visualizatsiya v Meditsine. 2023;5(2):32–37. In Russian: Тащилкина Ю.В. и соавт. Врожденная кистозно-аденоматозная мальформация легкого III типа (клинический случай). Визуализация в медицине. 2023;5(2):32–37.
Shestak EV. Type II congenital cystic adenomatoid malformation of the lung in a newborn: issues of early diagnosis. Ural Med J. 2022;21(1):77–84. https://doi.org/10.52420/2071-5943-2022-21-1-77-84. In Russian: Шестак Е.В. Кистозно-аденоматозная мальформация легкого II типа у новорожденного, проблемы ранней диагностики. Уральский медицинский журнал. 2022;21(1):77–84. https://doi.org/ 10.52420/2071-5943-2022-21-1-77-84.
Bakhuizen JJ, Postema AM, van Rijn RR, Schuppen J, et al. No pathogenic DICER1 gene variants in a cohort study of 28 children with congenital pulmonary airway malformation. J Pediatr Surg. 2024;59(3):459–463.
Ottomeyer M, KT et al. Early resection of a rare congenital pulmonary airway malformation causing severe progressive respiratory distress in a preterm neonate: a case report and review of the literature. BMC Pediatr. 2023;23:238. https://doi.org/10.1186/s12887-023-03969-1.
P. Goussard et al. Bronchoscopy findings in children with congenital lung and lower airway abnormalities. https://doi.org/10.1016/j.prrv.2023.10.01
Palla J, Sockrider MM. Congenital lung malformations. Pediatr Ann. 2019;48:e169–e174. https://doi.org/ 10.3928/19382359-20190326-02.
Patrick T, et al. Pediatric congenital lung malformations imaging guidelines and recommendations. Radiol Clin North Am. 2022;60:41–54. https://doi.org/10.1016/j.rcl.2021.08.002.
Rothenberg SS. Thoracoscopic lobectomy in infants and children. J Laparoendosc Adv Surg Tech A. 2021;31:1157–1161.
Seear M, Townsend J, Hoepker A, Jamieson D, McFadden D, Daigneault P, Glomb W. A review of congenital lung malformations with a simplified classification system for clinical and research use. Pediatr Surg Int. 2017;33:657–664.
Seohee J, et al. Thoracoscopic segmentectomy in children with congenital lung malformation. Sci Rep. 2023;13:9640. https://doi.org/10.1038/s41598-023-36700-5.
Stocker LJ, et al. The increasing incidence of foetal echogenic congenital lung malformations: an observational study. Prenat Diagn. 2015;35:148–153.
Yamataka A, Koga H, Ochi T, Imashimizu K, Suzuki K, Kuwatsuru R, et al. Pulmonary lobectomy techniques in infants and children. Pediatr Surg Int. 2017;33:483–495.
Zeng J, Liang J, Li L, et al. Surgical treatment for asymptomatic congenital pulmonary airway malformations in children: waiting or not? Eur J Pediatr Surg. 2021;31:509–517.
Zheng J, et al. Thoracoscopic versus open resection for symptomatic congenital pulmonary airway malformations in neonates: a decade-long retrospective study. BMC Pulm Med. 2021;21:82. https://doi.org/10.1186/s12890-021-01445-2.
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