Segmental resection for the treatment of congenital pulmonary malformations

Purpose

The purpose of this study was to compare clinical outcomes of segmental resection to lobectomy as increasing antenatal diagnosis of congenital pulmonary malformations has led to a shift in surgical management.

Methods

A retrospective institutional review for patients undergoing surgical excision of congenital pulmonary malformations was performed.

Results

Sixty-two patients with congenital pulmonary malformations were reviewed between 2001 and 2012. Forty-five were included for analysis. Malformations were subdivided into two groups, including congenital lobar emphysema (CLE) (n = 11, 24%) and intrapulmonary (IP) lesions (n = 34, 76%). Nineteen (56%) IP patients underwent segmental resection, and 15 (79%) were performed thoracoscopically without conversion to thoracotomy. None of these patients had recurrent disease. Lobectomy was performed in 11 (100%) CLE and 15 (44%) IP patients, and the majority were by thoracotomy. Median hospital stay was longer for the lobectomy group at 7 days when compared to the segmentectomy group at 2 days (p < 0.001). There was not a difference in complication rate (21% vs. 19%, p = 1.000) or in median number of chest tube days (2 vs. 3 days, p = 0.079) for segmentectomy versus lobectomy patients.

Conclusions

Segmental resections of congenital pulmonary malformations can be performed safely while conserving healthy lung tissue.