Kersten C M, Jansen M D G, Zuidweg M J P, Wijnen R M W H, Krasemann T B, Schnater J M
Department of Paediatric Surgery, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands.
Medicine master's student, Leiden University Medical Centre, Leiden, The Netherlands.
Eur J Pediatr Surg. 2025 Apr;35(2):147-158. doi: 10.1055/s-0044-1782237. Epub 2024 Mar 6.
Our objective was to explore the treatment preferences for bronchopulmonary sequestration (BPS) among an international group of specialized caregivers.
Sixty-three participants from 17 countries completed an online survey concerning the diagnostics, treatment, and follow-up. Recruitment took place among members of the Collaborative Neonatal Network for the first European Congenital Pulmonary Airway Malformation Trial Consortium and through the Association for European Pediatric and Congenital Cardiology working group database.
Most of the 63 participants were pediatric surgeons (52%), followed by pediatric pulmonologists (22%), and pediatric cardiologists (19%). The majority (65%) treated more than five cases per year and 52% standardly discussed treatment in a multidisciplinary team. Half of the participants (52%) based the management on the presence of symptoms, versus 32% on the intralobar or extralobar lesion localization. Centers with both surgical and interventional cardiac/radiological facilities (85%) preferred resection to embolization in symptomatic cases (62 vs. 15%). In asymptomatic cases too, resection was preferred over embolization (38 vs. 9%); 32% preferred noninterventional treatment, while 11% varied in preference. These treatment preferences were significantly different between surgeons and nonsurgeons ( < 0.05). Little agreement was observed in the preferred timing of intervention as also for the duration of follow-up.
This survey demonstrates a variation in management strategies of BPS, reflecting different specialist expertise. Most centers treat only a handful of cases per year and follow-up is not standardized. Therefore, management discussion within a multidisciplinary team is recommended. Recording patient data in an international registry for the comparison of management strategies and outcomes could support the development of future guidelines.
Level IV.
我们的目标是探讨国际专业护理人员群体对支气管肺隔离症(BPS)的治疗偏好。
来自17个国家的63名参与者完成了一项关于诊断、治疗和随访的在线调查。招募工作在首个欧洲先天性肺气道畸形试验联盟协作新生儿网络的成员中进行,并通过欧洲儿科和先天性心脏病学协会工作组数据库开展。
63名参与者中大多数是小儿外科医生(52%),其次是小儿肺科医生(22%)和小儿心脏病学家(19%)。大多数(65%)每年治疗超过5例病例,52%的人通常在多学科团队中讨论治疗方案。一半的参与者(52%)根据症状的有无进行管理,而32%是根据叶内或叶外病变定位。具备外科及介入心脏/放射设施的中心(85%)在有症状的病例中更倾向于手术切除而非栓塞治疗(62%对15%)。在无症状的病例中,同样更倾向于手术切除而非栓塞治疗(38%对9%);32%的人倾向于非介入性治疗,而11%的人偏好不一。外科医生和非外科医生之间的这些治疗偏好存在显著差异(<0.05)。在干预的首选时机以及随访时长方面,几乎没有达成一致意见。
这项调查表明BPS的管理策略存在差异,反映了不同的专业知识。大多数中心每年仅治疗少数病例,且随访不规范。因此,建议在多学科团队内进行管理讨论。将患者数据记录在国际登记处,以比较管理策略和结果,可为未来指南的制定提供支持。
四级。