Efficacy of segmental resection in patients with prenatally diagnosed congenital lung malformations.

Abstract

Lung segmental resection is a better treatment option than lobectomy for patients with prenatally diagnosed congenital lung malformations (CLMs). However, data are lacking on the effects of this procedure in prenatally diagnosed CLM patients. In this study, we explored whether parenchyma-saving resection was feasible in patients with this condition. A retrospective analysis was performed on 27 patients prenatally diagnosed with CLM, who subsequently underwent surgery between March 2011 and September 2015. Lobectomies and segmental resections were performed in 7 and 20 patients, respectively, based on the extent of cystic lesion invasion. The operative time significantly differed between the two groups (lobectomy group, 92.9 ± 32.0 min; segmental resection group, 126.5 ± 37.5 min). However, the duration of chest tube drainage and the length of hospital stay did not significantly differ between the groups. Chest computed tomography (CT) was performed during follow-up on all but 3 patients. We encountered 2 cases of remnant lesions, and one instance of a small emphysematous lesion around the surgical site was noted in either group. Lung-sparing surgery is relatively safe with few complications. In this study, the incidence of remnant lung lesions (a drawback of segmentectomy) was low. Thus, segmental resection affords results similar to those of lobectomy in patients with prenatally diagnosed CLM. Furthermore, segmental resection can preserve lung volume, thereby maintaining later pulmonary function. Therefore, elective segmental resection performed after precise identification of the lesions' locations may be highly beneficial for CLM patients.