Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Nov-Dec;28(6):508-513.
doi: 10.4103/jiaps.jiaps_115_23. Epub 2023 Nov 2.

Thoracoscopic Resection of Pulmonary Lesions in Israel: The Mentorship Approach

Emmanuelle Seguier-Lipszyc  1 , S Rothenberg  2 , Meir Mei-Zahav  3 , Patrick Stafler  3 , Yelena Zeitlin  4 , Inbal Samuk  5 , Yuri Peysakhovich  6 , Dragan Kravarusic  5
Affiliations

Thoracoscopic Resection of Pulmonary Lesions in Israel: The Mentorship Approach

Emmanuelle Seguier-Lipszyc et al. J Indian Assoc Pediatr Surg. 2023 Nov-Dec.

Abstract

Background: Most congenital pulmonary airway malformations (CPAMs) are detected antenatally. The majority of newborns are asymptomatic. Patients are prone to subsequent respiratory complications and to a lesser extent malignant transformation remains concerning. In Israel, until 2013, pediatric surgeries were performed by thoracotomy. To minimize its morbidity, we introduced thoracoscopy using a mentorship approach. We present our experience with thoracoscopic resections coordinated by the mentorship of a pediatric worldwide leader in his field and compare our results with resections performed by thoracotomy.

Materials and methods: A retrospective review of records of children operated between 2013 and 2020 was conducted. Data were compared using t-test for quantitative variables.

Results: Fifty patients were operated by thoracoscopy with a median age of 4 years, a thoracoscopic lobectomy performed in 68%. There was no conversion with a median length of stay (LOS) of 3½ days. Thirty patients were operated by thoracotomy by a thoracic surgeon with a median age of 3.5 years. A lobectomy was performed in 87% with a median LOS of 7 days.

Conclusions: Thoracoscopic lobectomy is a technically demanding procedure with a long learning curve, strongly related to the low volume of cases. The role of a mentorship program in acquiring those surgical skills is crucial through standardization of the technique applied and supervised by the mentor. Early thoracoscopy for congenital pulmonary lesions at an early age can be achieved with a low conversion rate and minimal complications creating a change in the paradigm of practice when considering surgery for CPAM in Israel.

Keywords: Bronchopulmonary sequestration; congenital pulmonary airway malformation; lobectomy; thoracoscopy.

PubMed Disclaimer

Conflict of interest statement

There are no conflicts of interest.

References

    1. Adams S, Jobson M, Sangnawakij P, Heetun A, Thaventhiran A, Johal N, et al. Does thoracoscopy have advantages over open surgery for asymptomatic congenital lung malformations? An analysis of 1626 resections. J Pediatr Surg. 2017;52:247–51. - PubMed
    1. Polites SF, Habermann EB, Zarroug AE, Thomsen KM, Potter DD. Thoracoscopic versus open resection of congenital cystic lung disease- utilization and outcomes in 1120 children in the United States. J Pediatr Surg. 2016;51:1101–5. - PubMed
    1. Criss CN, Musili N, Matusko N, Baker S, Geiger JD, Kunisaki SM. Asymptomatic congenital lung malformations: Is nonoperative management a viable alternative? J Pediatr Surg. 2018;53:1092–7. - PubMed
    1. Butterworth SA, Blair GK. Postnatal spontaneous resolution of congenital cystic adenomatoid malformations. J Pediatr Surg. 2005;40:832–4. - PubMed
    1. Kantor N, Wayne C, Nasr A. Symptom development in originally asymptomatic CPAM diagnosed prenatally: A systematic review. Pediatr Surg Int. 2018;34:613–20. - PubMed