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INTRODUCTION Our aim is to compare thoracoscopy to thoracotomy in the treatment of congenital lung malformations (CLM) in children. MATERIALS AND METHODS We report a case series and a subgroup analysis. Patients treated at our Centre for CLM (1991-2020) were divided in two groups: patients treated with video-assisted thoracoscopic surgery (VATS) and open thoracotomy (OT). Characteristics of the two groups were compared through statistical analysis (GraphPad Prism7®). A p-value<0.05 was considered statistically significant. RESULTS One hundred six patients were included: 58 in VATS group, 48 in OT group. Prenatal diagnosis was possible in 73.6%. The most frequent surgical procedures were lobectomy (43.4%) and sequestrectomy (22.6%). All VATS patients underwent lung exclusion, mostly by endobronchial blocker (69%). Mean operative time was 146.1 minutes (+/-52.04 SD) in VATS and 159.2 (+/-46.53 SD) in OT (p= 0,1973). Conversion to OT was necessary in 20.6% of VATS patients, but decreased in the last 5 years (6.2%). There were not any intraoperative complication. Respectively in VATS and OT group, length of stay (LOS) was 4.5 days +/-3.6SD versus 7.7+/-3.4SD (p<0.0001), chest tube duration 2.8 days +/-3.4SD versus 3.7+/-2.4SD (p<0.0001), antibiotic treatment duration 3.7 days +/-4.7SD versus 5+/-2.6SD (p = 0.1196). Postoperative complications were described in 22.6%. The commonest histological diagnosis (40.6%) was congenital pulmonary airway malformation. CONCLUSIONS VATS resulted a feasible, effective and safe technique. Operative time and postoperative complications were similar in VATS and OT groups. VATS conversion rate decreased in time. VATS had a statistically significant shorter LOS and chest tube duration. This article is protected by copyright. All rights reserved.
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Thoracoscopy versus thoracotomy for congenital lung malformations treatment: a single center experience.
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