Optimal timing for elective resection of asymptomatic congenital pulmonary airway malformations

Eric B. Jelin, Elizabeth M. O'Hare, Timothy Jancelewicz, Isam Nasr, Emily Boss, Daniel S. Rhee

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Purpose: We sought to determine optimal timing for CPAM resection within the first year of life. Methods: We queried the National Surgical Quality Improvement Program pediatric database from 2012 to 2015 for elective CPAM resections on patients less than 1 year of age. Patients were divided by age in months: 1–3 (n = 57), 4–6 (n = 135), and 6–12 (n = 214). Patient operative variables and 30-day postoperative outcomes were compared. Results: A total of 406 patients were included with no differences in demographics or comorbidities. Median operative time increased with each older age category (115 min, 152 min, 163 min, respectively; p < 0.01). Thoracoscopic approach was less utilized in 1–3 months (40.4%) compared to the older two age categories (65.9% and 69.6%, respectively; p < 0.01). There were no differences by age in major complications, conversion to open, or readmissions. On multivariate analysis, ASA class ≥ 3 (p < 0.01) and prolonged operative time (p < 0.01) were associated with a major complication. Furthermore, operations on patients aged 6–12 months were associated with increased operative time (p < 0.01) regardless of operative approach. Conclusion: Elective CPAM resections are equally safe in patients 1–12 months of age. Earlier resection including both open and thoracoscopic resection is associated with decreased operative time. Level of Evidence: IIc, Outcomes Research.

Original languageEnglish (US)
Pages (from-to)1001-1005
Number of pages5
JournalJournal of pediatric surgery
Volume53
Issue number5
DOIs
StatePublished - May 1 2018

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Operative Time
Lung
Quality Improvement
Comorbidity
Multivariate Analysis
Demography
Outcome Assessment (Health Care)
Databases
Pediatrics

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pediatrics, Perinatology, and Child Health

Cite this

Optimal timing for elective resection of asymptomatic congenital pulmonary airway malformations. / Jelin, Eric B.; O'Hare, Elizabeth M.; Jancelewicz, Timothy; Nasr, Isam; Boss, Emily; Rhee, Daniel S.

In: Journal of pediatric surgery, Vol. 53, No. 5, 01.05.2018, p. 1001-1005.

Research output: Contribution to journalArticle

Jelin, Eric B. ; O'Hare, Elizabeth M. ; Jancelewicz, Timothy ; Nasr, Isam ; Boss, Emily ; Rhee, Daniel S. / Optimal timing for elective resection of asymptomatic congenital pulmonary airway malformations. In: Journal of pediatric surgery. 2018 ; Vol. 53, No. 5. pp. 1001-1005.
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