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Lesion-to-Lung-Ratio in CPAMs - an important tool for a Therapeutic Approach? A retrospective clinical study
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  • Melanie Le,
  • Philip Harms,
  • Kersten Peldschus,
  • Carl-Martin Junge,
  • Stefan Klohs,
  • Katharina Wenke,
  • Christian Tomuschat,
  • Konrad Reinshagen
Melanie Le
University Medical Center Hamburg-Eppendorf

Corresponding Author:[email protected]

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Philip Harms
University Medical Center Hamburg-Eppendorf
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Kersten Peldschus
University Medical Center Hamburg-Eppendorf
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Carl-Martin Junge
Altona Children's Hospital
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Stefan Klohs
University Medical Center Hamburg-Eppendorf
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Katharina Wenke
University Medical Center Hamburg-Eppendorf
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Christian Tomuschat
University Medical Center Hamburg-Eppendorf
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Konrad Reinshagen
University Medical Center Hamburg-Eppendorf
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Abstract

Introduction: We would like to provide our case numbers and our experiences over the last eight years in this single-center retrospective analysis. Furthermore, we gathered pre-therapy Lesion-to-Lung-Ratios of CPAMs to retrospectively analyze the influence of these parameters on outcome. Methods: The data was collected between 2015 and 2022. Information was obtained from the electronic case record. Pre-therapy pulmonary lesion volumes [mm 3], Lesion-to-ipsilateral-Lung-Ratio and Lesion-to-both-Lungs-Ratio of CPAMs were calculated by computed tomography images using a specialized software. Results: 40 cases were identified; of these, 27 were CPAM, seven were pulmonary sequestration, four were bronchogenic cysts, and two were congenital lobar emphysema. Histological examination was performed at each resection with no signs of malignancy. The average age at surgery was 5,68 ± 5,36 months. The average time for CPAM surgery was 126 ± 53 minutes. The length of stay was an average of 6 ± 1,41 days vs. 17 ± 18,23 days (thoracoscopic vs. open). A larger Lesion-to-Lung-Ratio appears to be associated with a longer postoperative hospital stay and is more likely to present symptoms. Discussion and Conclusion: In cases where patients display no symptoms, mild symptoms, or smaller CPAM lesions, it may be reasonable to postpone a computed tomography scan of the thorax until about six months of age for re-evaluation of surgical indications. Smaller Lesion-to-Lung-Ratio and asymptomatic presentation are favorable for surgery. Both intraoperative and postoperative complications are relatively uncommon when operated in an experienced center. The value of thoracoscopic surgery is undeniable in well selected cases.