Outcome of anatomical versus non-anatomical lung resection for necrotizing pneumonia in children

Objective We aimed to evaluate the characteristics, complications and outcomes of necrotizing pneumonia (NP) requiring surgical intervention.Methods We conducted a retrospective study of all children who underwent surgical therapy for NP from January 2010 to December 2023. Patients were analyzed bas...

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Main Authors: Renato de Oliveira, Paulo Sergio Lucas da Silva, Nikkei Tamura, Leonardo Camargo, Emerson Yukio Kubo
Format: Article
Language:English
Published: BMJ Publishing Group 2024-12-01
Series:World Journal of Pediatric Surgery
Online Access:https://wjps.bmj.com/content/7/4/e000943.full
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author Renato de Oliveira
Paulo Sergio Lucas da Silva
Nikkei Tamura
Leonardo Camargo
Emerson Yukio Kubo
author_facet Renato de Oliveira
Paulo Sergio Lucas da Silva
Nikkei Tamura
Leonardo Camargo
Emerson Yukio Kubo
author_sort Renato de Oliveira
collection DOAJ
description Objective We aimed to evaluate the characteristics, complications and outcomes of necrotizing pneumonia (NP) requiring surgical intervention.Methods We conducted a retrospective study of all children who underwent surgical therapy for NP from January 2010 to December 2023. Patients were analyzed based on two surgical approaches: anatomic resection (AR) or non-AR (NAR).Results A total of 66 patients (median age: 36 months) required a surgical intervention for NP. A total of 37 patients received AR, 29 received NAR. The AR procedures were segmentectomy (n=29), lobectomy (n=8), bilobectomy (n=1) whereas NAR included wedge resection (n=13) and necrosectomy (n=16). The most common reasons for surgery were failure to respond to treatment (43.9%) and sepsis/septic shock (42.4%). A significantly greater proportion of patients in the AR group underwent surgery due to sepsis (p=0.023). There was no difference in the proportion of patients experiencing complications between the AR group (40.5%) and the NAR group (27.5%) (p=0.266). The majority of complications in both groups (68.0%) were categorized as minor, with 59.0% of cases occurring in patients who underwent AR. Prolonged air leak was the most frequent complication in both groups. There was no difference in the postoperative hospital stay, or duration of mechanical ventilation between the groups. There were no deaths.Conclusions Surgical intervention for NP may result in complications in one-third of patients, mostly minor and unlikely to significantly impact outcomes. Surgery should be tailored to the extent of parenchymal involvement.
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spelling doaj-art-c8a983e25be44d6ca8e98307766073ee2025-08-20T01:57:47ZengBMJ Publishing GroupWorld Journal of Pediatric Surgery2516-54102024-12-017410.1136/wjps-2024-000943Outcome of anatomical versus non-anatomical lung resection for necrotizing pneumonia in childrenRenato de Oliveira0Paulo Sergio Lucas da Silva1Nikkei Tamura2Leonardo Camargo3Emerson Yukio Kubo4Department of Thoracic Surgery, Federal University of Sao Paulo, Sao Paulo, Brazil1 Department of Pediatrics, Municipal Civil Servant Hospital, Sao Paulo, BrazilDivision of Thoracic Surgery, Hospital Estadual de Diadema, São Paulo, BrazilPediatric Intensive Care Unit, Hospital Estadual de Diadema, São Paulo, BrazilPediatric Intensive Care Unit, Hospital Estadual de Diadema, São Paulo, BrazilObjective We aimed to evaluate the characteristics, complications and outcomes of necrotizing pneumonia (NP) requiring surgical intervention.Methods We conducted a retrospective study of all children who underwent surgical therapy for NP from January 2010 to December 2023. Patients were analyzed based on two surgical approaches: anatomic resection (AR) or non-AR (NAR).Results A total of 66 patients (median age: 36 months) required a surgical intervention for NP. A total of 37 patients received AR, 29 received NAR. The AR procedures were segmentectomy (n=29), lobectomy (n=8), bilobectomy (n=1) whereas NAR included wedge resection (n=13) and necrosectomy (n=16). The most common reasons for surgery were failure to respond to treatment (43.9%) and sepsis/septic shock (42.4%). A significantly greater proportion of patients in the AR group underwent surgery due to sepsis (p=0.023). There was no difference in the proportion of patients experiencing complications between the AR group (40.5%) and the NAR group (27.5%) (p=0.266). The majority of complications in both groups (68.0%) were categorized as minor, with 59.0% of cases occurring in patients who underwent AR. Prolonged air leak was the most frequent complication in both groups. There was no difference in the postoperative hospital stay, or duration of mechanical ventilation between the groups. There were no deaths.Conclusions Surgical intervention for NP may result in complications in one-third of patients, mostly minor and unlikely to significantly impact outcomes. Surgery should be tailored to the extent of parenchymal involvement.https://wjps.bmj.com/content/7/4/e000943.full
spellingShingle Renato de Oliveira
Paulo Sergio Lucas da Silva
Nikkei Tamura
Leonardo Camargo
Emerson Yukio Kubo
Outcome of anatomical versus non-anatomical lung resection for necrotizing pneumonia in children
World Journal of Pediatric Surgery
title Outcome of anatomical versus non-anatomical lung resection for necrotizing pneumonia in children
title_full Outcome of anatomical versus non-anatomical lung resection for necrotizing pneumonia in children
title_fullStr Outcome of anatomical versus non-anatomical lung resection for necrotizing pneumonia in children
title_full_unstemmed Outcome of anatomical versus non-anatomical lung resection for necrotizing pneumonia in children
title_short Outcome of anatomical versus non-anatomical lung resection for necrotizing pneumonia in children
title_sort outcome of anatomical versus non anatomical lung resection for necrotizing pneumonia in children
url https://wjps.bmj.com/content/7/4/e000943.full
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