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Asymptomatic Congenital Lung Malformations: Timing of Resection Does Not Affect Adverse Surgical Outcomes

机译:无症状先天性肺部畸形:切除时机不会影响不良外科结果

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Background: Optimal timing for resection of asymptomatic congenital lung malformations (CLMs) remains controversial. The aim of this study is to define optimal timing for surgical intervention of patients with CLMs and define clinical variables that affect surgical outcomes. Methods: An IRB-approved retrospective analysis was conducted for patients undergoing surgery for CLMs between 2012 and 2017. Subjects were divided into cohorts based on timing of operative intervention. “Early intervention” was defined as surgery within 4 months of birth; “intermediate intervention” - between 4 to 6 months; and “late intervention” - 6 to 12 months. Surgical outcomes including intraoperative estimated blood loss (EBL), surgical time, postoperative pneumothorax, length of time chest tube stayed in, and hospital length of stay were compared among the three groups using Fisher’s exact test or Chi-squared test for categorical variables and one-way analysis of variance test for continuous variables. Results: We analyzed 66 patients who underwent surgery for CLM. There were no significant differences in baseline characteristics. Timing of surgery did not significantly correlate with postoperative outcomes. Specifically, there was no difference in operative time, EBL, postoperative pneumothorax, or length of hospital stay among the early, intermediate, and late intervention groups. Even after controlling for cyst-volume ratio (CVR), timing of surgery still did not affect postoperative outcomes. Conclusions: Surgical outcomes for resection of CLMs are not significantly affected by timing of surgery. We advocate for early intervention to decrease the incidence of complications that can occur with later intervention.
机译:背景:切除无症状先天性肺部畸形(CLMS)的最佳时间仍存在争议。本研究的目的是定义CLMS患者的手术干预的最佳时间,并确定影响外科结果的临床变量。方法:对2012年至2017年间接受手术的患者进行IRB批准的回顾性分析。基于手术干预的时机分为群组。 “早期干预”被定义为出生4个月内的手术; “中间干预” - 4至6个月之间;和“晚期干预” - 6至12个月。手术结果包括术中估计失血(EBL),手术时间,术后肺炎,时间长度胸部管道,以及使用Fisher的确切测试或Chi-Squared测试的三组进行分类变量和一个用于连续变量的方差测试的道路分析。结果:我们分析了66名接受CLM手术的患者。基线特征没有显着差异。手术时序与术后结果没有显着相关。具体而言,手术时间,EBL,术后肺炎或医院长度在早期,中间和晚期干预组中没有差异。即使在控制囊肿体积比(CVR)后,手术的时序仍然不会影响术后结果。结论:通过手术时机的切除切除手术结果不会显着影响。我们倡导早期干预以减少可能在后来干预中发生的并发症的发生率。

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