Open versus thoracoscopic approach in the surgical treatment of congenital pulmonary airway malformations: A retrospective cross-sectional analysis and review

Journal of Pediatric Surgery Open Pub Date : 2025-01-13 DOI:10.1016/j.yjpso.2025.100193

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

Level of evidence: 4

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开放与胸腔镜手术治疗先天性肺气道畸形：回顾性横断面分析与回顾

摘要先天性肺气道畸形（CPAMs）是一种罕见的肺发育异常，通常需要手术干预。本研究旨在比较开胸和胸腔镜治疗CPAM的资源利用率和住院结果。方法我们使用儿童住院患者数据库（KID），这是最大的公开可获得的全付款儿科住院患者护理登记处，以确定2016年和2019年因CPAM接受选择性手术治疗的20岁以下患者。根据国际疾病分类第十版（ICD-10）程序代码将患者分为开胸组或胸腔镜组。我们分析了两组患者人口学特征、并发症、总住院费用和住院时间的差异。结果共纳入749例患者，其中胸腔镜手术436例，开腹手术313例。人口统计学分析显示性别分布（p = 0.028）和种族分布(p <；0.001)。平均年龄相似(胸腔镜：1.2岁，开腹：1.7岁；P = 0.059)。两种入路的并发症无显著差异。胸腔镜入路与较低的平均总住院费用相关(74,719美元对82,146美元；P = 0.037)和较短的平均住院时间(3.1 vs. 4.5天；p & lt;结论本研究表明，胸腔镜入路治疗CPAM在降低住院费用和缩短住院时间方面具有优势，且不会显著增加并发症发生率。这些发现可以为儿科外科护理的临床决策和资源分配提供信息。需要进一步的研究来评估这些方法之间的长期结果和患者报告的措施。研究类型：回顾性横断面分析证据水平：4

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Journal of Pediatric Surgery Open

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