TY - JOUR
T1 - Thoracoscopic Resection of Pulmonary Lesions in Israel
T2 - The Mentorship Approach
AU - Seguier-Lipszyc, Emmanuelle
AU - Rothenberg, S.
AU - Mei-Zahav, Meir
AU - Stafler, Patrick
AU - Zeitlin, Yelena
AU - Samuk, Inbal
AU - Peysakhovich, Yuri
AU - Kravarusic, Dragan
N1 - Publisher Copyright:
© 2023 Journal of Indian Association of Pediatric Surgeons.
PY - 2023/11
Y1 - 2023/11
N2 - Background: Most congenital pulmonary airway malformations (CPAMs) are detected antenatally. The majority of newborns are asymptomatic. Patients are prone to subsequent respiratory complications and to a lesser extent malignant transformation remains concerning. In Israel, until 2013, pediatric surgeries were performed by thoracotomy. To minimize its morbidity, we introduced thoracoscopy using a mentorship approach. We present our experience with thoracoscopic resections coordinated by the mentorship of a pediatric worldwide leader in his field and compare our results with resections performed by thoracotomy. Materials and Methods: A retrospective review of records of children operated between 2013 and 2020 was conducted. Data were compared using t-test for quantitative variables. Results: Fifty patients were operated by thoracoscopy with a median age of 4 years, a thoracoscopic lobectomy performed in 68%. There was no conversion with a median length of stay (LOS) of 3 days. Thirty patients were operated by thoracotomy by a thoracic surgeon with a median age of 3.5 years. A lobectomy was performed in 87% with a median LOS of 7 days. Conclusions: Thoracoscopic lobectomy is a technically demanding procedure with a long learning curve, strongly related to the low volume of cases. The role of a mentorship program in acquiring those surgical skills is crucial through standardization of the technique applied and supervised by the mentor. Early thoracoscopy for congenital pulmonary lesions at an early age can be achieved with a low conversion rate and minimal complications creating a change in the paradigm of practice when considering surgery for CPAM in Israel.
AB - Background: Most congenital pulmonary airway malformations (CPAMs) are detected antenatally. The majority of newborns are asymptomatic. Patients are prone to subsequent respiratory complications and to a lesser extent malignant transformation remains concerning. In Israel, until 2013, pediatric surgeries were performed by thoracotomy. To minimize its morbidity, we introduced thoracoscopy using a mentorship approach. We present our experience with thoracoscopic resections coordinated by the mentorship of a pediatric worldwide leader in his field and compare our results with resections performed by thoracotomy. Materials and Methods: A retrospective review of records of children operated between 2013 and 2020 was conducted. Data were compared using t-test for quantitative variables. Results: Fifty patients were operated by thoracoscopy with a median age of 4 years, a thoracoscopic lobectomy performed in 68%. There was no conversion with a median length of stay (LOS) of 3 days. Thirty patients were operated by thoracotomy by a thoracic surgeon with a median age of 3.5 years. A lobectomy was performed in 87% with a median LOS of 7 days. Conclusions: Thoracoscopic lobectomy is a technically demanding procedure with a long learning curve, strongly related to the low volume of cases. The role of a mentorship program in acquiring those surgical skills is crucial through standardization of the technique applied and supervised by the mentor. Early thoracoscopy for congenital pulmonary lesions at an early age can be achieved with a low conversion rate and minimal complications creating a change in the paradigm of practice when considering surgery for CPAM in Israel.
KW - Bronchopulmonary sequestration
KW - congenital pulmonary airway malformation
KW - lobectomy
KW - thoracoscopy
UR - http://www.scopus.com/inward/record.url?scp=85180284903&partnerID=8YFLogxK
U2 - 10.4103/jiaps.jiaps_115_23
DO - 10.4103/jiaps.jiaps_115_23
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C2 - 38173630
AN - SCOPUS:85180284903
SN - 0971-9261
VL - 28
SP - 508
EP - 513
JO - Journal of Indian Association of Pediatric Surgeons
JF - Journal of Indian Association of Pediatric Surgeons
IS - 6
ER -