The Diagnostics and Management of Bronchopulmonary Sequestration: An International Survey among Specialized Caregivers.

IF 1.5 3区 医学 Q2 PEDIATRICS European Journal of Pediatric Surgery Pub Date : 2024-03-06 DOI:10.1055/s-0044-1782237
C M Kersten, M D G Jansen, M J P Zuidweg, R M W H Wijnen, T B Krasemann, J M Schnater
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Abstract

Background:  Our objective was to explore the treatment preferences for bronchopulmonary sequestration (BPS) among an international group of specialized caregivers.

Methods:  Sixty-three participants from 17 countries completed an online survey concerning the diagnostics, treatment, and follow-up. Recruitment took place among members of the Collaborative Neonatal Network for the first European Congenital Pulmonary Airway Malformation Trial Consortium and through the Association for European Pediatric and Congenital Cardiology working group database.

Results:  Most of the 63 participants were pediatric surgeons (52%), followed by pediatric pulmonologists (22%), and pediatric cardiologists (19%). The majority (65%) treated more than five cases per year and 52% standardly discussed treatment in a multidisciplinary team. Half of the participants (52%) based the management on the presence of symptoms, versus 32% on the intralobar or extralobar lesion localization. Centers with both surgical and interventional cardiac/radiological facilities (85%) preferred resection to embolization in symptomatic cases (62 vs. 15%). In asymptomatic cases too, resection was preferred over embolization (38 vs. 9%); 32% preferred noninterventional treatment, while 11% varied in preference. These treatment preferences were significantly different between surgeons and nonsurgeons (p < 0.05). Little agreement was observed in the preferred timing of intervention as also for the duration of follow-up.

Conclusions:  This survey demonstrates a variation in management strategies of BPS, reflecting different specialist expertise. Most centers treat only a handful of cases per year and follow-up is not standardized. Therefore, management discussion within a multidisciplinary team is recommended. Recording patient data in an international registry for the comparison of management strategies and outcomes could support the development of future guidelines.

Level of evidence: Level IV.

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支气管肺封闭的诊断和管理:对专业护理人员的国际调查。
背景:我们的目的是探讨国际专业护理人员对支气管肺动脉栓塞(BPS)治疗的偏好:来自 17 个国家的 63 名参与者完成了一项有关诊断、治疗和随访的在线调查。调查对象是欧洲首个先天性肺气道畸形试验联盟新生儿合作网络的成员,以及欧洲儿科和先天性心脏病学协会工作组数据库的成员:63名参与者中大多数是儿科外科医生(52%),其次是儿科肺病专家(22%)和儿科心脏病专家(19%)。大多数参与者(65%)每年治疗五例以上病例,52%的参与者在多学科团队中对治疗进行标准讨论。半数参与者(52%)根据是否存在症状进行治疗,而 32% 则根据椎管内或椎管外病变定位进行治疗。同时拥有手术和介入心脏/放射设施的中心(85%)更倾向于对有症状的病例进行切除而非栓塞治疗(62% 对 15%)。在无症状病例中,切除术也比栓塞术更受青睐(38% 对 9%);32% 的病例倾向于非介入治疗,而 11% 的病例在选择上各不相同。外科医生和非外科医生对这些治疗方法的偏好存在明显差异(P 结论:外科医生和非外科医生对这些治疗方法的偏好存在明显差异:这项调查表明,BPS 的治疗策略存在差异,反映了不同的专科专业知识。大多数中心每年只治疗少数病例,随访也没有标准化。因此,建议在多学科团队内进行管理讨论。在国际登记册中记录患者数据,以便对管理策略和结果进行比较,这有助于制定未来的指南:证据等级:IV 级。
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来源期刊
CiteScore
3.90
自引率
5.60%
发文量
66
审稿时长
6-12 weeks
期刊介绍: This broad-based international journal updates you on vital developments in pediatric surgery through original articles, abstracts of the literature, and meeting announcements. You will find state-of-the-art information on: abdominal and thoracic surgery neurosurgery urology gynecology oncology orthopaedics traumatology anesthesiology child pathology embryology morphology Written by surgeons, physicians, anesthesiologists, radiologists, and others involved in the surgical care of neonates, infants, and children, the EJPS is an indispensable resource for all specialists.
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