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. 2025 Mar 10;25(1):94.
doi: 10.1186/s12893-025-02827-7.

Impact of pulmonary infection on thoracoscopic surgery outcomes in children with CPAM: a retrospective study

Cui-Xia Yuan  1 , Chun Wu  1 , Zheng-Xia Pan  1 , Yong-Gang Li  2
Affiliations

Impact of pulmonary infection on thoracoscopic surgery outcomes in children with CPAM: a retrospective study

Cui-Xia Yuan et al. BMC Surg. .

Abstract

Background: Pulmonary infection is a common clinical complication in children with congenital pulmonary airway malformation (CPAM). Surgical intervention has been proven effective in managing this condition. We aim to evaluate the impact of pulmonary infection on the outcomes of total thoracoscopic procedures in children with CPAM.

Methods: This was a single-center retrospective study. CPAM patients who underwent total thoracoscopic surgery at a tertiary care center from January 2013 to December 2023 were divided into three groups based on pulmonary infection status: non-infection (NI), hidden infection (HI), and pulmonary infection (PI). Clinical characteristics and operation-related outcomes were compared among the groups.

Results: A total of 154 children with CPAM who underwent thoracoscopic surgery were categorized into three groups based on pulmonary infection: the NI group (27 cases), HI group (56 cases), and PI group (71 cases). The conversion rate to thoracotomy was 14.8%, 23.2%, and 29.2% respectively across the three groups. 116 cases were successfully completed thoracoscopically. There were no significant differences in gender distribution among the three groups (p > 0.05), but statistically significant (p < 0.05) in age and weight. Significant differences emerged in operative time and blood loss (p < 0.05), but no significant variations were found in transfusion requirements, chest tube duration, ventilator use duration, or hospital stay length (p > 0.05). In postoperative pulmonary complications, a statistically significant difference was found regarding pneumothorax incidence among all three groups (p < 0.05), whereas no significant differences (p > 0.05) emerged concerning atelectasis or pneumonia incidences across these cohorts.

Conclusions: Pulmonary infection is the most prevalent complication in CPAM and exhibits a high rate of hidden infections, thereby complicating surgical intervention and increasing associated risks. Early thoracoscopic intervention prior to infection manifestation can optimize surgical outcomes and reduce associated complications.

Keywords: Children; Congenital pulmonary airway malformation; Pulmonary infection; Total thoracoscopic surgery.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This retrospective study is in compliance with the Helsinki Declaration and approved by the Children’s Hospital of Chongqing Medical University (Approval No. 2023–575). After review by the Ethics Committee of the Children’s Hospital Affiliated to Chongqing Medical University on December 23, 2023, this study utilizing medical records and biological specimens obtained from prior clinical treatments was determined not to pose unnecessary risks to participants. Consequently, the committee agreed to waive the requirement for informed consent, provided that patient privacy is strictly protected. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart for patient selection
Fig. 2
Fig. 2
Distribution of operation time, blood loss and the incidence of pneumothorax among NI,HI and PI groups
See this image and copyright information in PMC

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