Malformaciones pulmonares congénitas: ¿Qué impacto tiene la presencia de síntomas preoperatorios en el resultado quirúrgico?

IF 1.5 4区医学 Q2 PEDIATRICS

Anales de pediatria Pub Date : 2025-05-01 DOI:10.1016/j.anpedi.2025.503835

María López-Díaz , Ester Fernández Díaz , Indalecio Cano Novillo , Elena Bergón , Rocío Morante Valverde , Alberto Galindo Izquierdo , Juan L. Antón-Pacheco

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Abstract

Introduction

The management of congenital lung malformations (CLMs) is controversial because most of them are asymptomatic. The aim of our study was to analyze the association of preoperative symptoms with surgical outcomes in patients with CLMs treated by means of minimally invasive surgery (MIS).

Patients and methods

Retrospective study of patients with CLM treated with MIS in our hospital between 2003 and 2023. We recorded data on the following variables: demographic characteristics, size, type and location of the lesion, mediastinal shift, clinical symptoms, surgical time, conversion to open surgery, duration of chest drainage (days), length of stay and postoperative complications.

Results

The sample included 116 patients, 98 (84.4%) asymptomatic and 18 (15.5%) with clinically significant symptom: infectious in 10 (55.5%) and respiratory distress in eight. The most frequent histopathological type was congenital pulmonary airway malformation (35.5%), followed by intralobar sequestration (27.3%), and the lower lobes were most commonly involved (78.4%). Larger lesion size on the CT scan was significantly associated with the development of symptoms (P = .027) and with an increased frequency of conversion to open surgery. However, the incidence of postoperative complications was not greater in the symptomatic group.

Conclusions

Postoperative complications were not significantly more frequent in the symptomatic group of patients. Larger lesion size on imaging was associated with a significantly increased probability of developing symptoms, so these patients may benefit from early surgical resection.

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先天性肺畸形：术前症状的存在对手术结果有什么影响？

先天性肺畸形（CLMs）的治疗存在争议，因为大多数先天性肺畸形是无症状的。本研究的目的是分析经微创手术（MIS）治疗的CLMs患者术前症状与手术结果的关系。患者与方法回顾性分析我院2003 ~ 2023年接受MIS治疗的CLM患者。我们记录了以下变量的数据：人口统计学特征、病变的大小、类型和位置、纵隔移位、临床症状、手术时间、转开腹手术、胸腔引流持续时间（天）、住院时间和术后并发症。结果116例患者中，无症状98例（84.4%），有明显临床症状18例（15.5%），其中感染性10例（55.5%），呼吸窘迫8例（15.5%）。最常见的组织病理学类型为先天性肺气道畸形（35.5%），其次是肺叶内隔离（27.3%），最常累及的是下肺叶（78.4%）。CT扫描显示的较大病变大小与症状的发展显著相关（P = 0.027），并与转向开放手术的频率增加有关。然而，有症状组的术后并发症发生率并不高。结论有症状组患者术后并发症发生率无明显增高。影像学显示的较大病变与出现症状的可能性显著增加相关，因此这些患者可能从早期手术切除中获益。

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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来源期刊

Anales de pediatria 医学-小儿科

CiteScore

2.10

自引率

4.80%

发文量

155

审稿时长

44 days

期刊介绍： La Asociación Española de Pediatría tiene como uno de sus objetivos principales la difusión de información científica rigurosa y actualizada sobre las distintas áreas de la pediatría. Anales de Pediatría es el Órgano de Expresión Científica de la Asociación y constituye el vehículo a través del cual se comunican los asociados. Publica trabajos originales sobre investigación clínica en pediatría procedentes de España y países latinoamericanos, así como artículos de revisión elaborados por los mejores profesionales de cada especialidad, las comunicaciones del congreso anual y los libros de actas de la Asociación, y guías de actuación elaboradas por las diferentes Sociedades/Secciones Especializadas integradas en la Asociación Española de Pediatría.