Abstract
PURPOSE: To compare the clinical outcomes of single operative port thoracoscopic anatomical lesion resection (TALR) with multi-portal video-assisted thoracic surgery (M-VATS) in the treatment of congenital lung malformations (CLMs) located in pulmonary segments S9-10, and to evaluate its safety and feasibility in routine practice. METHODS: We retrospectively analysed 46 paediatric CLMs cases treated thoracoscopically at our institution from January 2023 to January 2025. Patients were grouped by surgical approach: 13 underwent single operative port TALR, and 33 underwent M-VATS. Clinical parameters were compared between groups. RESULTS: Compared to M-VATS, the single operative port TALR showed significantly reduced blood loss (P = 0.01), chest tube time (P = 0.04), hospital stays (P = 0.04), and incision length (P < 0.01). No bronchopleural fistulas, conversions to open surgery, no recurrence or residual lesions occurred in either group. CONCLUSION: single operative port TALR is safe, feasible, minimally invasive, and offers excellent cosmetic outcomes, representing a promising surgical technique for treating CLMs involving segments S9-10.