2. Methods
The study design was a retrospective review of the data from 24
symptomatic neonates with CCAM who underwent thoracoscopic or open
resection at the Foshan Women and Children Hospital Affiliated to
Southern Medical University, from April 2010 to April 2020. The
pathological results of all cases were confirmed to be CCAM or CCAM
combined with pulmonary sequestration (PS). The medical records were
reviewed for preoperative, intraoperative and postoperative variables.
Preoperative variables included gestational age at birth, sex, body
weight, head circumference, location of the CCAM, lesion size, cystic
adenomatoid malformation volume ratio (CVR)7,
respiratory symptoms, associated anomalies and age at operation.
Intraoperative variables included length od surgical incision, operation
time and operative blood loss. Postoperative variables included
postoperative ventilator days, duration of chest tube use, length of
postoperative hospital stay and postoperative complications.
All cases were performed with preoperative CT or MRI scans and 3D
reconstruction to better determine the range of the lesion (Fig. 1-A).
Surgery was performed after the infection had adequately subsided.
Central venous and bladder catheters were placed.
For the thoracoscopic resection procedure, general anesthesia, tracheal
intubation and nonsingle lung ventilation were used. The patient was
placed in a semiprone position with the affected side elevated to more
easily expose the lesion. The first 5-mm trocar for thoracoscopy (5-mm
300, Olympus) was placed at the tip of the scapula. The second 5-mm
trocar was inserted at the posterior axillary line, and the third 3-mm
trocar was inserted at the interscapular region. Both trocars were
parallel to the tip of the scapula. (Fig. 1-B) All trocars were sutured
and fixed to prevent them from being pulled out. Carbon dioxide pressure
was 3 mmHg to 5 mmHg. Thoracoscopic lobectomy or wedge resection was
performed according to the size of the lesion (Fig. 1-C). An
ultrasonically activated scalpel was used for wedge resection, and the
lung wound was sutured with 4-0 absorbable thread. Hemo-locks were used
to clip the main blood vessel and main bronchus during lobectomy. The
chest tube was conventionally placed.
Statistical analyses were performed using SPSS Statistics (version
12.0.0.0). The Mann-Whitney U test was used to compare continuous
variables with nonparametric variables. Fisher’s exact test and 2 × 2
contingency tables were used to compare categorical variables.
Statistical significance was defined as a P value of less than .05. This
study was approved by Medical Ethics Committee of Foshan Women and
Children Hospital Affiliated to Southern Medical University
(FSFY-MEC-2020-031).