Effect analysis of flexible bronchoscopy in thoracoscopic surgery for congenital pulmonary airway malformation

Abstract

The objective of this study is to investigate the clinical efficacy of flexible bronchoscopy (FB) in thoracoscopic surgery for congenital pulmonary airway malformation (CPAM) in pediatric patients. We randomly divided the CPAM patients who underwent thoracoscopic surgery at our hospital from May 2022 to January 2024 into 2 groups based on whether they received FB treatment before and after thoracoscopic surgery. Group A included 24 patients who received FB treatment, while Group B consisted of 21 patients who underwent conventional thoracoscopic surgery. We performed a comparative analysis of the clinical data between the 2 groups. All patients successfully underwent thoracoscopic surgery and were followed up for at least 3 months. The postoperative atelectasis rate in Group A (0%) was significantly lower than that in Group B (28.6%), with a statistically significant difference (P = .018). There was no statistically significant difference in other postoperative complications, and no severe postoperative complications occurred in either group. The chest drainage time, total drainage volume, postoperative inflammatory markers, and postoperative hospitalization time in Group A were all significantly lower than those in Group B (P = .000, P = .014, P = .001, P = .022, P = .006, P = .001). No significant differences were observed in gender, age, or prenatal diagnosis rate between the 2 groups. Additionally, there were no significant differences in surgical methods, operation time, intraoperative blood loss, or postoperative ventilator use between the 2 groups. The application of FB in thoracoscopic surgery for CPAM is both effective and feasible. It can effectively alleviate postoperative inflammatory reactions, reduce drainage volume, shorten postoperative hospital stays, and prevent postoperative atelectasis.

Keywords: congenital pulmonary airway malformation; flexible bronchoscopy; lobectomy; segmentectomy.

Figure 1.

Preoperative chest CT of CPAM. CPAM = congenital pulmonary airway malformation.

Figure 2.

Tracheal prominence.

Figure 3.

Lower left lobe.

Figure 4.

Bronchoalveolar lavage.

Figure 5.

Recovery of bronchoalveolar lavage fluid.

Figure 6.

Three-hole incision marking.

Figure 7.

Electric hook marks lesions in the outside.

Figure 8.

Processing of arteries, veins, and trachea in the posterior outer basal segment (S9 + 10) of the left lower lobe of the lung.

Figure 9.

The cutting closure device removes the lesion along the marked area.

Figure 10.

Postoperative 3-month chest CT.