Surgical Management Of Congenital Thoracic Disorders: A 15-Year Center Experience

Authors

  • Catarina Pereira Moita Thoracic Surgery Department – Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Portugal https://orcid.org/0009-0001-4107-5856
  • Catarina Figueiredo Thoracic Surgery Department – Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Portugal
  • Zenito Cruz Thoracic Surgery Department – Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Portugal
  • João Maciel Thoracic Surgery Department – Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Portugal
  • Ana Rita Costa Thoracic Surgery Department – Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Portugal
  • João Santos Silva Thoracic Surgery Department – Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Portugal
  • João Eurico Reis Thoracic Surgery Department – Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Portugal
  • Paulo Calvinho Thoracic Surgery Department – Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Portugal

DOI:

https://doi.org/10.48729/pjctvs.418

Keywords:

Congenital, Thoracic Malformation, Congenital Lung Malformation, Congenital Pulmonary Airway Malformation, Bronchogenic Cyst, Pulmonary Sequestration, Congenital Lobar Emphysema

Abstract

Introduction: Congenital thoracic disorders represent a spectrum of fetal lung bud development abnormalities, which may affect breathing capacity and quality of life. We aim to evaluate the impact of surgery in the treatment of 4 major congenital conditions.
Materials and Methods: We performed a retrospective cohort analysis of patients who underwent surgical treatment in our tertiary center, from 2007 to 2022.
Results: Over the 15-year period, we treated 33 patients, with a male predominance of 55%. 22 patients (67%) were asymptomatic. When symptomatic, the recurrence of respiratory infections was the most common clinical presentation (18%). In 13 patients (39%), diagnosis was achieved through fetal ultrasonography. This study encompassed 13 patients with pulmonary sequestration (39%), 11 patients with bronchogenic cysts (33%), 7 patients with congenital pulmonary airway malformation (21%) and 2 patients with congenital lobar emphysema (6%). Considering solely lung malformation conditions, we accounted 22 patients with a median age of 3 [1-67] years-old. Surgery comprised bilobectomy (9%), lobectomy (77%), lobectomy with wedge resection (5%), segmentectomy (5%) and wedge resection (5%). Concerning bronchogenic cysts, we treated 11 patients with a median age of 19 [14-66] years-old. We identified 1 hilar, 1 intrapulmonary and 9 mediastinal lesions, of which 4 were paraesophageal, 4 were subcarinal and 1 was miscellaneous. Overall, surgery was conducted by thoracotomy in 61% of patients, VATS in 33% and RATS in 6%. The median drainage time was 3 [1-40] days and median hospital stay was 4 [1-41] days. There were no cases of mortality. Ensuing, 94% of patients experienced clinical improvement after surgery.
Conclusion: Early diagnosis of congenital thoracic malformations increased considerably with the improvement in imaging technology and prenatal screening. Treatment may include expectant conservative treatment. However, in selected cases, surgery may play an important role in symptomatic control and prevention of disease progression.

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Published

07-07-2024

How to Cite

1.
Pereira Moita C, Figueiredo C, Cruz Z, Maciel J, Costa AR, Santos Silva J, Reis JE, Calvinho P. Surgical Management Of Congenital Thoracic Disorders: A 15-Year Center Experience. Rev Port Cir Cardiotorac Vasc [Internet]. 2024 Jul. 7 [cited 2024 Jul. 18];31(2):23-9. Available from: https://pjctvs.com/index.php/journal/article/view/418

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