Optimal timing for elective resection of asymptomatic congenital pulmonary airway malformations

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

Research output: Contribution to journalArticle

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)
JournalJournal of Pediatric Surgery
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

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

Keywords

  • Congenital pulmonary airway malformation
  • Lung resection
  • Operative time
  • Thoracoscopy

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

Cite this

@article{526aaba7196644c2a9548ef194b436d1,
title = "Optimal timing for elective resection of asymptomatic congenital pulmonary airway malformations",
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.",
keywords = "Congenital pulmonary airway malformation, Lung resection, Operative time, Thoracoscopy",
author = "Eric Jelin and O'Hare, {Elizabeth M.} and Tim Jancelewicz and Isam Nasr and Emily Boss and Daniel Rhee",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.jpedsurg.2018.02.032",
language = "English (US)",
journal = "Journal of Pediatric Surgery",
issn = "0022-3468",
publisher = "W.B. Saunders Ltd",

}

TY - JOUR

T1 - Optimal timing for elective resection of asymptomatic congenital pulmonary airway malformations

AU - Jelin, Eric

AU - O'Hare, Elizabeth M.

AU - Jancelewicz, Tim

AU - Nasr, Isam

AU - Boss, Emily

AU - Rhee, Daniel

PY - 2018/1/1

Y1 - 2018/1/1

N2 - 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.

AB - 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.

KW - Congenital pulmonary airway malformation

KW - Lung resection

KW - Operative time

KW - Thoracoscopy

UR - http://www.scopus.com/inward/record.url?scp=85042878160&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85042878160&partnerID=8YFLogxK

U2 - 10.1016/j.jpedsurg.2018.02.032

DO - 10.1016/j.jpedsurg.2018.02.032

M3 - Article

C2 - 29514740

AN - SCOPUS:85042878160

JO - Journal of Pediatric Surgery

JF - Journal of Pediatric Surgery

SN - 0022-3468

ER -