Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Do More With Less? Lobectomy vs Segmentectomy for Patients With Congenital Pulmonary Malformations

Beatrice Trabalza Marinucci MD
* ORCID logo ,
Cecilia Menna MD
ORCID logo ,
Paolo Scanagatta MD
,
Silvia Fiorelli MD
,
Matteo Tiracorrendo MD
,
Giuseppe Naldi MD
,
Alessandro Inserra MD
ORCID logo ,
Francesco Macchini MD
,
Erino Angelo Rendina MD
,
Mohsen Ibrahim MD
Version 1 : Received: 7 July 2023 / Approved: 10 July 2023 / Online: 10 July 2023 (03:57:02 CEST)

A peer-reviewed article of this Preprint also exists.

Marinucci, B.T.; Menna, C.; Scanagatta, P.; Fiorelli, S.; Tiracorrendo, M.; Naldi, G.; Inserra, A.; Macchini, F.; Rendina, E.A.; Ibrahim, M. Do More with Less? Lobectomy vs. Segmentectomy for Patients with Congenital Pulmonary Malformations. J. Clin. Med. 2023, 12, 5237. Marinucci, B.T.; Menna, C.; Scanagatta, P.; Fiorelli, S.; Tiracorrendo, M.; Naldi, G.; Inserra, A.; Macchini, F.; Rendina, E.A.; Ibrahim, M. Do More with Less? Lobectomy vs. Segmentectomy for Patients with Congenital Pulmonary Malformations. J. Clin. Med. 2023, 12, 5237.

Abstract

Background: Congenital Pulmonary Malformations (CPMs) are rare benign lesions potentially causing infective complications and/or malignant transformation requiring surgery even when asymptomatic. CPMs are infrequent in adult but potentially detected at any age. There is not a consensus indicating the correct extent of resection in both adults and paediatrics. This retrospective multicentric study aims to identify the appropriate surgical resection to prevent the recurrence of related respiratory symptoms. Methods: Between 2010 and 2020, a total of 96 patients (adult and pediatric) underwent surgery for CPMs in 4 centers. A 2:1 propensity score matching (considering sex and lesion side) was performed, identifying 2 groups: 50 patients underwent lobectomy (group A) and 25 sub-lobar resections (group B). Clinical and histopathological characteristics, early and late complications and symptom’s recurrence were retrospectively analyzed and compared between the two groups by univariate and multivariate analyses. Results: Patients who underwent lobectomy had a statistically significant lower rate of recurrence (4% vs 24% of group B, p = 0.014) and a lower rate of intraoperative complications (p = 0.014). Logistic regression identified sub-lobar resection (p=0.040), intra- and post-operative complications (p=0.105 and 0.022) and associated developed neoplasm (p=0.062) as possible risk factors for symptoms recurrence after surgery. Conclusions: Pulmonary lobectomy seems to be the most effective surgical treatment for CPMs, guaranteeing stable remission of symptoms and a lower rate of intra- and postoperative complications. To our knowledge this is one of the largest studies comparing lobectomy and sub-lobar resections in patients affected by CPMs, considering the low incidence worldwide.

Keywords

Congenital Pulmonary Malformations; thoracic surgery; lobectomy; pulmonary sequestration; congenital cystic adenomatoid malformation

Subject

Medicine and Pharmacology, Pulmonary and Respiratory Medicine

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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