ArticleEuropean journal of pediatrics2026
Safety and long-term outcomes of surgical intervention in pediatrics with necrotizing pneumonia: a retrospective cohort study.
Article in European journal of pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
This study aimed to analyze the evolving etiology, clinical features, surgical outcomes, and long-term prognosis of pediatric necrotizing pneumonia (NP). Data were collected from 398 children diagnosed with NP between January 2017 and June 2025, among whom 42 (10.55%) required surgical intervention due to failed medical therapy. Pathogens were identified in 95.2% of cases, with mycoplasma pneumoniae being the most common (52.50%). Preoperative complications were present in 83.33% of patients. The mean operative time was 140.71 ± 49.84 min, intraoperative blood loss was 119.79 ± 49.97 mL, chest tube duration was 7.83 ± 3.05 days, and postoperative hospital stay was 14.74 ± 3.53 days. Compared with the non-resection group, the parenchymal resection group had significantly longer operative time (P < 0.001) and greater blood loss (P < 0.05), but no significant differences were observed in drainage duration or length of hospital stay (P > 0.05). Five postoperative pulmonary adverse events occurred, all of which resolved completely with conservative management. During a median follow-up of 64.4 months (range 5-101 months), no recurrence or mortality was observed.
conclusionTimely surgical intervention, including lung resection when necessary, is safe and associated with excellent long-term recovery in pediatric NP, providing crucial evidence to guide surgical decision-making. WHAT IS KNOWN: • Necrotizing pneumonia (NP) is a severe, increasingly recognized complication of community-acquired pneumonia in preschool children, characterized by pulmonary parenchymal destruction and cavity formation. • While surgical intervention is required for pediatric NP after failed medical therapy or complications, a clear understanding of its safety, perioperative outcomes, and long-term prognosis is lacking. WHAT IS NEW: • The predominance of mycoplasma pneumoniae updates the disease's etiology and calls for routine testing of atypical pathogens. • Timely and individualized surgical intervention plays a pivotal role in the management of pediatric NP when medical therapy fails or complications develop.
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