Operation outcomes.

BackgroundCongenital lung malformation (CLM) is usually characterized by single-lobe involvement and multilobe involvement is uncommon. There is a lack of experience in the clinical features and surgical treatment of unilateral multilobar CLM. Therefore, this study aims to summarize the clinical characteristics and evaluate the safety and feasibility of thoracoscopic lung sparing resection in the treatment of unilateral multilobar CLM.MethodsA retrospective study was conducted on 34 patients with unilateral multilobar CLM, and 34 unilobar patients were randomly selected as the control group in West China Hospital of Sichuan University from 2014.1 to 2021.1. Clinical, operation and follow-up outcomes were compared between the two groups.ResultsTwelve (35.2%) patients developed preoperative symptoms in the multilobar group more than 4(11.7%) the unilobar group (p = 0.02), the main preoperative symptom was infection; The multilobar group and unilobar group showed significant differences in mean intraoperative blood loss (13.3 mL vs. 7.5 mL; p = 0.02) and mean surgical time (95.6 min vs. 47.5 min; p = 0.037). The median length of postoperative hospital stay and the median chest tube placement time in the multilobar group were significantly longer (5 d vs.3 d, p = 0.045; 2 d vs.1 d, p = 0.031). There were one (2.9%) patient in unilobar group and 4(11.7%) patients in multilobar group developed complications postoperatively, which is no significant differences between the two groups(p = 0.16). No complications such as thoracic deformity, mediastinal deviation, scoliosis or recurrence were observed in either group at follow-up.ConclusionsUnilateral multilobar CLM cases are more susceptible to develop symptoms than unilobar cases. Thoracoscopic lung sparing resection in the treatment of unilateral multilobar CLM has high safety and can effectively avoid serious complications of unilateral multiple lobectomy or pneumonectomy.背景 先天性肺畸形（Congenital lung malformation, CLM）多以单叶受累为主要表现，多叶受累较为少见。目前临床对于单侧多叶性先天性肺畸形的特征表现与外科治疗经验均相对匮乏。为此，本研究旨在总结单侧多叶性CLM的临床特点，并评估胸腔镜肺保留切除术治疗单侧多叶性CLM的安全性与可行性。 方法 本研究为回顾性研究，纳入2014年1月至2021年1月期间四川大学华西医院收治的34例单侧多叶性CLM患者，同时随机选取同期34例单叶性CLM患者作为对照组。对比两组患者的临床资料、手术相关指标及随访结局。 结果 多叶组共有12例（35.2%）患者出现术前症状，占比高于单叶组的4例（11.7%），组间差异具有统计学意义（p=0.02），术前主要症状为肺部感染；多叶组与单叶组的平均术中失血量（13.3 mL vs. 7.5 mL；p=0.02）与平均手术时长（95.6 min vs. 47.5 min；p=0.037）均存在显著差异。多叶组患者的术后住院中位时间与胸腔引流管留置中位时间均显著长于单叶组（5 d vs. 3 d，p=0.045；2 d vs. 1 d，p=0.031）。单叶组术后并发症发生率为2.9%（1例），多叶组为11.7%（4例），两组差异无统计学意义（p=0.16）。随访期间，两组均未出现胸廓畸形、纵隔偏移、脊柱侧弯或疾病复发等并发症。 结论 单侧多叶性CLM患者较单叶性CLM患者更易出现临床症状。胸腔镜肺保留切除术治疗单侧多叶性CLM安全性良好，可有效规避单侧多叶切除或全肺切除术所致的严重并发症。