European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie
December 19, 2025 · via Europe PMC
Learning Curve and Early Outcomes of Thoracoscopic Anatomical Lesion Resection for Congenital Pulmonary Airway Malformation in Children: A Single-surgeon Experience.
Lin M, Liao J, Li L.
AI summary — for doctors, generated from the abstract only
In a single-surgeon series of 154 children undergoing thoracoscopic anatomical lung lesion resection for congenital pulmonary airway malformation, outcomes improved significantly once the surgeon passed roughly 39 cases, with low overall complication (1.9%) and residual lesion (2.6%) rates.
What was studied
A retrospective single-surgeon case series (January 2019-December 2023) of 154 children with congenital pulmonary airway malformation (CPAM) who underwent thoracoscopic anatomic lesion resection, using cumulative sum (CUSUM) analysis to characterize the surgeon's learning curve and comparing perioperative parameters and 1-year outcomes across learning-curve phases.
Key findings
- Postoperative complications occurred in 3 of 154 patients (1.9%), and residual lesions were identified in 4 cases (2.6%).
- Once the surgeon's case volume exceeded 39 cases (marking transition to a proficiency phase), significant reductions were seen in operative time, intraoperative blood loss, postoperative hospital stay, and mechanical ventilation duration compared with the earlier learning phase.
- The incidence of residual lesions decreased as the surgeon progressed to proficiency.
- The authors identify precise identification of lesion boundaries and dissection as key technical points for this procedure.
Clinical relevance
The findings suggest that thoracoscopic anatomic resection for CPAM is a feasible and relatively safe technique, but also that achieving proficiency requires a substantial case volume (around 39 cases in this series), which may have implications for surgical training and credentialing in this specialized procedure.
Who should care
Limitations
This was a single-center, single-surgeon study with a limited case number and no long-term follow-up data, and the authors explicitly state further validation through multi-center studies is needed.
A surgeon needed roughly 39 cases of thoracoscopic lung resection for congenital airway malformations before operative times, blood loss, and residual lesion rates meaningfully improved, highlighting a real learning curve for this specialized technique.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Objective
To investigate the key points in performing thoracoscopic anatomic pulmonary lesion resection procedures, as well as analyze the characteristics of the learning curve associated with the surgery.
Methods
We retrospectively collected clinical data and 1-year follow-up outcomes of children diagnosed with congenital pulmonary airway malformation (CPAM) who underwent thoracoscopic anatomic lesion resection in our hospital from January 2019 to December 2023. Perioperative and short-term follow-up results were analyzed and surgical experiences and insights were summarized. Furthermore, the cumulative sum (CUSUM) method was employed to plot the learning curve of a single surgeon performing thoracoscopic anatomic resection, and the impact of different phases on perioperative parameters and early follow-up outcomes was investigated.
Results
This study included 154 patients undergoing thoracoscopic anatomic lesion resection. Postoperative complications occurred in three patients (1.9%), and residual lesions were identified in four cases (2.6%). When a single surgeon's procedural volume exceeded 39 cases, marking the transition to the proficiency phase, significant reductions were observed in operative time, intraoperative blood loss, postoperative hospital stay, and postoperative mechanical ventilation duration compared with the learning phase (all p < 0.05). No significant differences were found in postoperative drainage volume and chest tube duration.
Conclusion
The key to thoracoscopic anatomic lesion resection lies in identifying the lesion boundaries and achieving precise dissection. Our study showed that this surgical approach is relatively safe and feasible for children with CPAM, with favorable perioperative and 1-year postoperative outcomes. Moreover, as surgeons progress to proficiency, perioperative outcomes improve and the incidence of residual lesions decreases. However, as a single-center study with a limited number of cases and due to a lack of long-term follow-up data, the safety and efficacy of this technique still require further validation through multi-center studies.
DOI
10.1055/a-2767-7356
PMID
41418817
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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