Takahisa Tainaka, Chiyoe Shirota, Wataru Sumida, Satoshi Makita, Hizuru Amano, Yoko Kano, Akihiro Yasui, Daiki Kato, Takuya Maeda, Yousuke Gohda, Hiroki Ishii, Kazuki Ota, Akinari Hinoki, Hiroo Uchida
Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa, Nagoya, Aichi, 466-8550, Japan.
Pediatr Surg Int. 2025 Jan 11;41(1):62. doi: 10.1007/s00383-024-05925-4.
To analyze the frequency and predictive factors of the development of postoperative pectus excavatum and scoliosis in children who underwent surgery for cystic lung disease.
This study examined patients who underwent surgery for cystic lung disease (open and thoracoscopic) between July 2000 and December 2018 with a > 3-year follow-up period. Lesion size, surgical outcomes, and subsequent musculoskeletal complications were compared between the open surgery and thoracoscopic surgery groups. Univariate and multivariate analyses were performed to identify predictive factors.
Overall, 90 patients (19 and 71 patients in the open and thoracoscopic groups, respectively) were included in this study. There was no significant difference in the incidence of pectus excavatum or scoliosis between open and thoracoscopic surgery; however, Haller's index and Cobb angle were significantly higher in the open surgery group. In the univariate analysis, neonatal surgery and lesion size were substantial predictors of musculoskeletal malformations.
Postoperative musculoskeletal deformities emerge after surgical treatment for cystic lung disease, with thoracoscopic surgery showing advantages in selected dimensions. Neonatal surgery and lesion size are pivotal prognostic factors for musculoskeletal complications. Further corroborative multicenter studies are imperative to substantiate these findings and foster enhanced patient outcomes.
分析接受囊性肺疾病手术的儿童术后漏斗胸和脊柱侧弯发生的频率及预测因素。
本研究纳入了2000年7月至2018年12月期间接受囊性肺疾病手术（开放手术和胸腔镜手术）且随访期超过3年的患者。比较开放手术组和胸腔镜手术组的病变大小、手术结果及随后的肌肉骨骼并发症。进行单因素和多因素分析以确定预测因素。
本研究共纳入90例患者（开放手术组19例，胸腔镜手术组71例）。开放手术和胸腔镜手术在漏斗胸或脊柱侧弯的发生率上无显著差异；然而，开放手术组的哈勒指数和 Cobb 角显著更高。在单因素分析中，新生儿期手术和病变大小是肌肉骨骼畸形的重要预测因素。
囊性肺疾病手术治疗后会出现术后肌肉骨骼畸形，胸腔镜手术在某些方面显示出优势。新生儿期手术和病变大小是肌肉骨骼并发症的关键预后因素。需要进一步的多中心对照研究来证实这些发现并改善患者预后。
