J.Jpn. Surg. Soc.. 124(6): 514-520, 2023

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Feature topic

THORACIC SURGEONS’ OPINIONS ON CONGENITAL CYSTIC LUNG DISEASE

Congenital cystic lung disease (CCLD) is an important respiratory disease for pediatric surgeons, and most cases are detected in infancy. However, some cases develop or are discovered incidentally in adulthood, which is important for general thoracic surgeons as well. Although no guidelines on treatment strategies exist, symptomatic cases diagnosed because of respiratory distress or infections are considered absolute surgical indications. Many surgeons also recommend surgery for asymptomatic patients to avoid the risk of infection or malignancy. The basic surgical procedure is an anatomic lung resection beyond lobectomy for complete resection of the lesion in both adult and pediatric patients. Video-assisted thoracic surgery (VATS) is widely used for adult patients. VATS is also preferable in pediatric cases owing to its minimal invasiveness; however, the mismatch between body and device sizes makes it difficult to use. The development of small devices and scopes has recently progressed to overcome this problem, and many reports have been published on innovations in the VATS technique for children. It is hoped that the applications of this technique will expand to neonatal cases in the future. Furthermore, robot-assisted thoracic surgery is expected to be adapted for CCLD.

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