Open versus thoracoscopic approach in the surgical treatment of congenital pulmonary airway malformations: A retrospective cross-sectional analysis and review
Jean Dai , Jesse York , Baylor Schexnayder , Frankie Fike
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引用次数: 0
Abstract
Introduction
Congenital pulmonary airway malformations (CPAMs) are rare developmental lung abnormalities that often require surgical intervention. This study aimed to compare resource utilization and in-hospital outcomes between open thoracotomy and thoracoscopic approaches for CPAM treatment.
Methods
We used the Kids' Inpatient Database (KID), the largest publicly available all-payer pediatric inpatient care registry, to identify patients under 20 years old who were treated with elective surgery for CPAM in 2016 and 2019. Patients were categorized into open thoracotomy or thoracoscopic groups based on International Classification of Disease, Tenth Revision (ICD-10) procedure codes. We analyzed differences in demographic characteristics, complications, total cost of stay, and length of hospital stay between the two groups.
Results
The study included 749 patients (436 thoracoscopic, 313 open). Demographic analysis revealed significant differences in sex distribution (p = 0.028) and race (p < 0.001) between groups. The mean age was similar (thoracoscopic: 1.2 years, open: 1.7 years; p = 0.059). Complications were not significantly different between approaches. The thoracoscopic approach was associated with lower mean total cost of stay ($74,719 vs. $82,146; p = 0.037) and shorter mean length of stay (3.1 vs. 4.5 days; p < 0.001) compared to the open approach (Table 1).
Conclusion
This study suggests that the thoracoscopic approach for CPAM treatment may offer advantages in terms of reduced hospital costs and shorter length of stay without significantly increasing complication rates. These findings could inform clinical decision-making and resource allocation in pediatric surgical care. Further research is needed to assess long-term outcomes and patient-reported measures between these approaches.
Type of study: retrospective cross-sectional analysis
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