Surgical outcome after thoracoscopic lung resections for congenital lung lesions in children

Abstract Purpose: This study aimed to determine the complications after video assisted thoracoscopic surgery (VATS) for congenital lung lesions in children. Methods: All children undergoing a lung resection between January 2009 and June 2022 were retrospectively identified. Both early (<30 days) and late postoperative pulmonary complications were determined. The primary endpoint was postoperative complications within 30 days. Results: In total, 56 patients were included, with a median age of 13 months (IQR 9-37). A VATS lobectomy were performed in 46 patients (82%), an extralobar sequestration in 8 patients (14%), an wedge resection in 1 patient and a segment resection in 1 patient. During the COVID pandemic, less resections were performed with an increase in symptomatic patients. A conversion to open occurred in 6 patients (11%), of which a preoperative lung infection was associated with an increased risk thereof (p=0.004). The median follow-up was 22 months (IQR 7-57) and all patients were alive. A postoperative complication (Clavien Dindo ≥3) occurred in 9 patients and complications without the need of intervention in 6 patients. Conclusion: VATS lobectomy is a relatively safe procedure in children, even under one year of age. A preoperative lung infection increases the risk of conversion to open surgery.