Muscle-sparing thoracotomy combined with mechanically stapled lung resection for benign lung disorders: functional results and quality of life

Pediatr Surg Int. 2006 Jun;22(6):491-5. doi: 10.1007/s00383-006-1687-7. Epub 2006 May 3.

Abstract

We set out to review our experience with resection of benign lung lesions performed using mechanical stapling devices via a muscle-sparing thoracotomy, and provide data on long-term morbidity, functional results, and quality of life (QOL). Fifty-two patients with a benign lung disorder were included in the study. All underwent a lung resection with mechanical staplers via a muscle-sparing thoracotomy. Medical records were retrospectively searched for postoperative complications. Nineteen patients (36.5%) also underwent a final follow-up including clinical examination, radiological investigations, functional tests, and assessment of QOL by a standardized questionnaire. No intra-operative complications occurred. The resection was anatomical (lobectomy) in 28 (53%) children and wedge in 25 (47%). Five cases (9.6%) required secondary surgery. Of the 19 children undergoing long-term follow-up, 3 (16%) had musculoskeletal anomalies and 6 (31.5%) respiratory symptoms. All X-rays were normal. Spirometry was abnormal in 9 cases (47.3%). QOL was excellent/good in 17 cases (89.5%) and sufficient in 2 (10.5%). An abnormal spirometric pattern was significantly more frequent in cases with a poorer QOL. In conclusion, stapled resection via a muscle-sparing thoracotomy is a good option to perform lung resections. However, a muscle-sparing approach does not avoid entirely long-term musculoskeletal complications. QOL is good in nearly 90% of cases, but respiratory symptoms and abnormal spirometric function can be found in one third and half of the patients, respectively. An abnormal spirometry is more common in patients with a poorer QOL. Systematic radiological follow-up is unnecessary.

MeSH terms

  • Adolescent
  • Chi-Square Distribution
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Lung Diseases / physiopathology
  • Lung Diseases / surgery*
  • Male
  • Postoperative Complications
  • Quality of Life*
  • Retrospective Studies
  • Spirometry
  • Statistics, Nonparametric
  • Surgical Stapling*
  • Surveys and Questionnaires
  • Thoracotomy / methods*
  • Treatment Outcome