학술논문
Congenital lung malformations: a nationwide survey on management aspects by the Italian Society of Pediatric Surgery.
Document Type
Academic Journal
Author
Pio L; Pediatric Thoracic and Airway Surgery, IRCCS Giannina Gaslini, Genoa, Italy. luca.pio@stjude.org.; Department of Surgery, MS133, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105-3678, USA. luca.pio@stjude.org.; Gentilino V; Unit of Pediatric Surgery, Woman and Child Department, Filippo del Ponte Hospital-ASST Sette Laghi, Varese, Italy.; Macchini F; ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.; Scarpa AA; Pediatric Surgery Unit, Pietro Barilla Children's Hospital, Parma, Italy.; Lo Piccolo R; Department of Emergency, Critical Area and Pediatric Surgery, Meyer University Children's Hospital, University of Florence, Florence, Italy.; Conforti A; Neonatal Surgery Unit, Department of Medical and Surgical Neonatology, Bambino Gesù Children Hospital-Research Institute, Rome, Italy.; Ratta A; Pediatric Surgery Unit, Infermi Hospital, Rimini, Italy.; Guanà R; Department of Pediatric General Surgery, Regina Margherita Children's Hospital, Azienda Ospedaliero-Universitaria Città Della Salute E Della Scienza, Turin, Italy.; Molinaro F; Division of Pediatric Surgery, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy.; Costanzo S; Pediatric Surgery Department, Vittore Buzzi' Children's Hospital, Milan, Italy.; Riccipetitoni G; Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.; Pediatric Surgery Unit, Department of Maternal and Child Health, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.; Lisi G; Department of Pediatric Surgery 'Spirito Santo', Hospital of Pescara 'G. D'annunzio', University Chieti-Pescara, Pescara, Italy.; Midrio P; Pediatric Surgery, Cà Foncello Hospital, Treviso, Italy.; Pediatric Surgery, University of Padua, Padua, Italy.; Tocchioni F; Department of Pediatric and Neonatal Surgery, Meyer Children's Hospital, Florence, Italy.; Cobellis G; Unit of Pediatric Surgery, Salesi Children's Hospital, Marche Polytechnic University, Ancona, Italy.; Volpe A; Pediatric Surgery Unit, Women's and Children's Health Department, University Hospital of Padua, Padua, Italy.; Zolpi E; Department of Pediatric Surgery and Pediatric Minimally Invasive Surgery and New Technologies, San Bortolo Hospital, Vicenza, Italy.; Morandi A; Department of Pediatric Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.; Ciardini E; Chirurgia Pediatrica Ospedale S.Chiara, Trento, Italy.; Vella C; Azienda Ospedaliero-Universitaria di Ferrara, Ferrara, Italy.; Grella MG; Department of Pediatric Surgery, Santobono Pausilipon Children's Hospital, Naples, Italy.; Sergio M; Policlinico Universitario di Palermo, Palermo, Italy.; Guida E; Department of Pediatric Surgery, Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy.; Nanni L; Fondazione Policlinico Universitario 'A. Gemelli' IRCCS, Rome, Italy.; Ceccanti S; Pediatric Surgery Unit, Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Azienda Ospedaliero-Universitaria Policlinico Umberto I, Rome, Italy.; Di Benedetto V; Pediatric Surgery Unit, University Hospital of Catania, Catania, Italy.; Cheli M; Department of Paediatric Surgery, Papa Giovanni XXIII Hospital, Bergamo, Italy.; Garzi A; Dipartimento di Chirurgia Pediatrica e Robotica, Università di Salerno, Salerno, Italy.; Nobili M; Pediatric Surgery Unit, University of Foggia, Foggia, Italy.; Gabriele V; AOU Maggiore Della Carità, Novara, Italy.; Boroni G; Department of Pediatric Surgery, Azienda Ospedaliera Spedali Civili, Brescia, Italy.; Incerti F; Department of Pediatric Surgery, Umberto Bosio Center for Digestive Diseases, The Children Hospital AO SS Antonio E Biagio E Cesare Arrigo, Alessandria, Italy.; Zampieri N; Woman and Child Hospital, Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Verona, Italy.; Cacciaguerra S; Deparment of Pediatric Surgery, Ospedale Garibaldi, Catania, Italy.; Ceccarelli PL; Pediatric Surgery Department, Policlinico di Modena, Modena, Italy.; Escolino M; Department of Translational Medical Sciences, Federico II University, Naples, Italy.; Briganti V; Department of Pediatric Surgery and Urology Unit, San Camillo Forlanini Hospital, Rome, Italy.; Gori D; Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126, Bologna, Italy.; Esposito C; Department of Translational Medical Sciences, Federico II University, Naples, Italy.; Gamba P; Pediatric Surgery Unit, Women's and Children's Health Department, University Hospital of Padua, Padua, Italy.; Pediatric Surgery, Department of Women's and Children's Health, Padua University, Padua, Italy.; Gennari F; Department of Pediatric General Surgery, Regina Margherita Children's Hospital, Azienda Ospedaliero-Universitaria Città Della Salute E Della Scienza, Turin, Italy.; Inserra A; General Surgery Unit, Department of Surgery, Bambino Gesù Children's Hospital - IRCCS, Rome, Italy.; Department of Systems Medicine, University of Tor Vergata, Rome, Italy.; Dall'Igna P; Department of Emergencies and Organ, Transplantation Azienda Ospedaliero-Universitaria Consorziale Ospedale Pediatrico Giovanni XXIII, Bari, Italy.; University of Bari, Bari, Italy.; Romeo C; Unit of Pediatric Surgery, Department of Human Pathology of Adult and Childhood 'Gaetano Barresi', University of Messina, Messina, Italy.; Bagolan P; Neonatal Surgery Unit, Department of Medical and Surgical Neonatology, Bambino Gesù Children Hospital-Research Institute, Rome, Italy.; Department of Systems Medicine, University of Tor Vergata, Rome, Italy.; Bleve C; Department of Pediatric Surgery and Pediatric Minimally Invasive Surgery and New Technologies, San Bortolo Hospital, Vicenza, Italy.; Chiarenza F; Department of Pediatric Surgery and Pediatric Minimally Invasive Surgery and New Technologies, San Bortolo Hospital, Vicenza, Italy.; Morini F; Department of Pediatric and Neonatal Surgery, Meyer Children's Hospital, Florence, Italy.; Pelizzo G; Pediatric Surgery Department, Vittore Buzzi' Children's Hospital, Milan, Italy.; Torre M; Pediatric Thoracic and Airway Surgery, IRCCS Giannina Gaslini, Genoa, Italy.
Source
Publisher: Springer International Country of Publication: Germany NLM ID: 8609169 Publication Model: Electronic Cited Medium: Internet ISSN: 1437-9813 (Electronic) Linking ISSN: 01790358 NLM ISO Abbreviation: Pediatr Surg Int Subsets: MEDLINE
Subject
Language
English
Abstract
Introduction: Over the years, congenital lung malformations (CLM) management remains a controversial topic in pediatric thoracic surgery. The Italian Society of Pediatric Surgery performed a national survey to study the current management variability among centers, trying to define national guidelines and a standardized approach of children with congenital lung malformations.
Methods: Following a National Society approval, an electronic survey including 35 items on post-natal management was designed, focusing on surgical, anesthesiology, radiology and pneumology aspects. The survey was conducted contacting all pediatric surgical units performing thoracic surgery.
Results: 39 pediatric surgery units (97.5%) participated in the study. 13 centers (33.3%) were classified as high-volume (Group A), while 26 centers (66.7%) were low volume (Group B). Variances in diagnostic imaging protocols were observed, with Group A performing fewer CT scans compared to Group B (p = 0.012). Surgical indications favored operative approaches for asymptomatic CLM and pulmonary sequestrations in both groups, while a wait-and-see approach was common for congenital lobar emphysema. Surgical timing for asymptomatic CLM differed significantly, with most high-volume centers operating on patients younger than 12 months (p = 0.02). Thoracoscopy was the preferred approach for asymptomatic CLM in most of centers, while postoperative long-term follow-up was not performed in most of the centers.
Conclusion: Thoracoscopic approach seems uniform in asymptomatic CLM patients and variable in symptomatic children. Lack of uniformity in surgical timing and preoperative imaging assessment has been identified as key areas to establish a common national pattern of care for CLM.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Methods: Following a National Society approval, an electronic survey including 35 items on post-natal management was designed, focusing on surgical, anesthesiology, radiology and pneumology aspects. The survey was conducted contacting all pediatric surgical units performing thoracic surgery.
Results: 39 pediatric surgery units (97.5%) participated in the study. 13 centers (33.3%) were classified as high-volume (Group A), while 26 centers (66.7%) were low volume (Group B). Variances in diagnostic imaging protocols were observed, with Group A performing fewer CT scans compared to Group B (p = 0.012). Surgical indications favored operative approaches for asymptomatic CLM and pulmonary sequestrations in both groups, while a wait-and-see approach was common for congenital lobar emphysema. Surgical timing for asymptomatic CLM differed significantly, with most high-volume centers operating on patients younger than 12 months (p = 0.02). Thoracoscopy was the preferred approach for asymptomatic CLM in most of centers, while postoperative long-term follow-up was not performed in most of the centers.
Conclusion: Thoracoscopic approach seems uniform in asymptomatic CLM patients and variable in symptomatic children. Lack of uniformity in surgical timing and preoperative imaging assessment has been identified as key areas to establish a common national pattern of care for CLM.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)