Liu Chenyu, Yu Xuejiao, Cheng Kaisheng, Luo Dengke, Yuan Miao, He Taozhen, Xu Chang
Department of Pediatric Surgery, West China Hospital of Sichuan University, Chengdu, China.
Department of Clinical Pathology, West China Hospital of Sichuan University, Chengdu, China.
Front Pediatr. 2022 Apr 14;10:859343. doi: 10.3389/fped.2022.859343. eCollection 2022.
Whether to operate on asymptomatic patients with congenital lung malformations (CLMs) remains controversial. Our study intended to find out the proportion of hidden infection in CLMs and its effect on surgery, to provide help for the management of asymptomatic CLMs patients.
A retrospective review of the medical records of patients with asymptomatic CLMs from January 2011 to December 2020 was performed in our center. Selected asymptomatic patients were divided into a non-hidden infection group (NHI) and a hidden infection group (HI).
A total of 581 asymptomatic CLMs patients were included in this study. Thirty-two percent of asymptomatic CLMs patients had hidden infection in the lesion. Among various CLMs diseases, intralobular pulmonary sequestration had the highest percentage of hidden infection (48.8%). With age, the proportion of HI gradually increased. Patients in the HI and NHI groups were 223 and 121. The incidence of pleural adhesion and focal abscess in the HI group were 14.9 and 7.4%. Statistical significances were shown between the two groups in intraoperative blood loss ( = 0.002), operation time ( = 0.045), chest tube drainage time ( < 0.001), postoperative hospital stay ( < 0.001), and air leak ( = 0.012).
The proportion of HI detected by postoperative pathological results was high and they could increase the difficulty and risk of surgery. Therefore, early surgery may be a more appropriate choice for the management of asymptomatic CLMs patients.
对于先天性肺发育异常（CLMs）的无症状患者是否进行手术仍存在争议。我们的研究旨在找出CLMs中隐匿性感染的比例及其对手术的影响，为无症状CLMs患者的管理提供帮助。
对本中心2011年1月至2020年12月期间无症状CLMs患者的病历进行回顾性分析。将入选的无症状患者分为非隐匿性感染组（NHI）和隐匿性感染组（HI）。
本研究共纳入581例无症状CLMs患者。32%的无症状CLMs患者病变存在隐匿性感染。在各种CLMs疾病中，肺叶内隔离症的隐匿性感染比例最高（48.8%）。随着年龄增长，HI的比例逐渐增加。HI组和NHI组患者分别为223例和121例。HI组胸膜粘连和局灶性脓肿的发生率分别为14.9%和7.4%。两组在术中出血量（ = 0.002）、手术时间（ = 0.045）、胸腔闭式引流时间（ < 0.001）、术后住院时间（ < 0.001）和气漏（ = 0.012）方面存在统计学差异。
术后病理结果检测出的HI比例较高，且会增加手术难度和风险。因此，早期手术可能是无症状CLMs患者管理的更合适选择。
