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Single-direction thoracoscopic lobectomy for incomplete pulmonary fissure in children with congenital pulmonary airway malformation: initial experience and propensity score-matched analysis

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Abstract

Purpose

To evaluate the safety and efficacy of single-direction lobectomy for congenital pulmonary airway malformation (CPAM), especially with incomplete pulmonary fissure (IPF).

Methods

A total of 279 patients who underwent thoracoscopic lobectomy in our hospital from January 2019 to January 2022 were analyzed. Fifty-nine children were identified as the single-direction group, and the details of the surgical application are described. The degree of pulmonary fissure completeness was quantified intraoperatively. Propensity score matching was conducted and another 59 patients who underwent conventional lobectomy were matched as the control group.

Results

The median age of the patients was 4.9 months and the mean body weight was 7.7 kg. For patients with complete pulmonary fissure, there were no statistical differences between two groups in terms of operative time, intraoperative blood loss, length of chest tube, and hospital stay. For patients with IPF, there were statistical differences between the single-direction group and the control group in terms of operative times (89.10 ± 7.97 min vs. 97.41 ± 7.51 min, P < 0.001), intraoperative blood loss (10.86 ± 5.36 mL vs. 14.14 ± 6.56 mL P = 0.042), and postoperative complications (P = 0.035).

Conclusion

IPF increases the operative difficulty of thoracoscopic lobectomy for CPAM, and the single-direction lobectomy technique is an effective and safe treatment for IPF.

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Data availability

The data that support the findings of this study are available on request from the corresponding author. Requests to access these datasets should be directed to hjx7072@126.com.

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Acknowledgements

We thank all doctors in our centre for their helpful advice and discussions.

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Authors and Affiliations

  1. Department of Cardiac Surgery, Fujian Children’s Hospital (Fujian Branch of Shanghai Children’s Medical Center), College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, 966 Hengyu Road, Fujian Province, Fuzhou City, China

    **-** Huang, Qiang Chen, Song-Ming Hong, Jun-Jie Hong & Hua Cao

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  2. Qiang Chen
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Contributions

J-XH and HC made a significant contribution to the conception and design of the work. J-JH and S-MH drafted the work and revised it critically for important intellectual content. QC and J-XH are responsible for all aspects of the work and ensure that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. All authors read and approved the final manuscript.

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Correspondence to **-** Huang.

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**-** Huang, Qiang Chen, Song-Ming Hong, Jun-Jie Hong, and Hua Cao have no conflicts of interest or financial ties to disclose.

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Huang, JX., Chen, Q., Hong, SM. et al. Single-direction thoracoscopic lobectomy for incomplete pulmonary fissure in children with congenital pulmonary airway malformation: initial experience and propensity score-matched analysis. Pediatr Surg Int 39, 174 (2023). https://doi.org/10.1007/s00383-023-05464-4

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