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Short And Medium Term Prognosis Evaluation Of Infants With Congenital Pulmonary Airway Malformations After Surgery
Huimin Xia, Le Li, Jiachi Liao;
Guangzhou Women and Children's Medical Center, Guangzhou, China
BACKGROUND: Congenital pulmonary airway malformations (CPAM) are a group of rare disorders of congenital lung dysplasia. The study aimed to investigate pulmonary function outcomes, imaging descriptions, and complications in infants with CPAM after surgery, providing reference value for clinical surgical management.
METHODS:Infants (< 3 years of age) with CPAM who underwent surgery at Guangzhou Women and Childrens’ Medical Center between June 2021 and June 2022 were recruited into the study. We measured their pulmonary function after surgery and selected healthy individuals of similar age as the control group for pulmonary function tests and statistically analysed the results. Pulmonary function, computed tomography (CT) images and complications were followed up in the first year after surgery.
RESULTS:A total of 30 infants were included in the study. They all underwent thoracoscopic surgery with an average age of 10.13 ± 1.47 months. The short-term pulmonary function results measured within one month after surgery showed that the normal rate was 26.7%, and VT (P=0.002), TI/TE (P=0.002), TPTEF/TE (P=0.000), VPTEF/VE (P=0.000) and MEF/MIF (P=0.004) decreased. 15 of them underwent medium-term pulmonary function tests after one year, with a normal rate of 60%, and there were not statistically significant in VT/kg (P=0.512), RR (P=0.638), Ti/Te (P=0.298), TPTEF/TE (P=0.129), VPTEF/VE (P=0.198), PTEF (P=0.868) and MEF/MIF (P=0.336) compared with the normal control group. The comparison between the lobectomy and the segmentectomy was not statistically significant (P>0.05). The incidence of postoperative complications was 26.7%, with 5 cases having short-term complications and 3 infants developing late complications. CT images showed that 20% did not meet the expected rehabilitation goals.
CONCLUSIONS:Short-term postoperative pulmonary function was abnormal in infants with CPAM, suggesting airway obstruction. The medium-term pulmonary function can return to normal, indicating that surgery in infancy had little effect on their pulmonary function. Moreover, it was found that the choice of lobectomy and segmentectomy had no significant effect on the pulmonary function. Further study is necessary to confirm the long-term result.
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