---
title: "Safety and Long-Term Outcomes of Surgical Treatment for Pediatric Necrotizing Pneumonia"
id: "pubmed-42665678"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42665678"
content_type: "clinical_feed_article"
specialty: "Pediatrics"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42665678/"
doi: "10.1007/s00431-026-07365-9"
published_at: "2026-08-29T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Safety and Long-Term Outcomes of Surgical Treatment for Pediatric Necrotizing Pneumonia
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42665678
- **Specialty:** [Pediatrics](https://medichelpline.com/clinical-feed/pediatrics.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42665678/)
- **DOI:** [10.1007/s00431-026-07365-9](https://doi.org/10.1007%2Fs00431-026-07365-9)
- **Published At:** 2026-08-29T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This retrospective cohort studied 398 children diagnosed with **necrotizing pneumonia (NP)** from January 2017 to June 2025; 42 (10.55%) underwent surgical intervention after failed medical therapy. - Pathogens were identified in 95.2% of surgically treated cases; **Mycoplasma pneumoniae** was the most frequent single pathogen (52.50%). - Preoperative complications were present in 83.33% of children who had surgery. - Operative metrics for the surgical cohort: mean operative time 140.71 ± 49.84 minutes; mean intraoperative blood loss 119.79 ± 49.97 mL; mean chest tube duration 7.83 ± 3.05 days; mean postoperative hospital stay 14.74 ± 3.53 days. - Patients who underwent parenchymal resection had significantly longer operative time (P 0.05). - Five postoperative pulmonary adverse events occurred; all resolved with conservative management and there were no surgical-site mortalities. - Median follow-up was 64.4 months (range 5–101 months); during follow-up there were no recurrences or deaths reported. - Authors conclude that timely and individualized surgical intervention, including **lung resection** when indicated, is safe and linked to excellent long-term recovery in pediatric NP. - Ethics approval and written informed consent were obtained; authors declared no competing interests.
## Clinical Analysis & Structured Key Points
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Affiliations Expand ### Affiliations * 1 Clinical Medical School, Qinghai University, Xining, China. * 2 Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China. * 3 Department of Endocrinology, Genetics and Metabolism, Children's Hospital of Nanjing Medical University, Nanjing, China. * 4 Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China. damingirlnanjing@126.com. * 5 Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China. ertongxinlianxin@163.com. * 6 Department of Cardiovascular Surgery, Qinghai University Affiliated Hospital, Xining, China. ertongxinlianxin@163.com. # Contributed equally. * PMID: **42665678** * DOI: [ 10.1007/s00431-026-07365-9 ](https://doi.org/10.1007/s00431-026-07365-9) Item in Clipboard # Safety and long-term outcomes of surgical intervention in pediatrics with necrotizing pneumonia: a retrospective cohort study Yang Wang et al. Eur J Pediatr. 2026. Show details Display options Display options Format Abstract PubMed PMID Eur J Pediatr Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Eur+J+Pediatr%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Eur+J+Pediatr%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42665678/) . 2026 Aug 29;185(9):701. doi: 10.1007/s00431-026-07365-9. ### Authors [Yang Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+Y&cauthor_id=42665678)[#](https://pubmed.ncbi.nlm.nih.gov/42665678/#short-view-equal-contrib-explanation "Contributed equally")[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42665678/#short-view-affiliation-1 "Clinical Medical School, Qinghai University, Xining, China.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42665678/#short-view-affiliation-2 "Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China."), [Xuewen Yuan](https://pubmed.ncbi.nlm.nih.gov/?term=Yuan+X&cauthor_id=42665678)[#](https://pubmed.ncbi.nlm.nih.gov/42665678/#short-view-equal-contrib-explanation "Contributed equally")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42665678/#short-view-affiliation-3 "Department of Endocrinology, Genetics and Metabolism, Children's Hospital of Nanjing Medical University, Nanjing, China."), [Mingtang Ye](https://pubmed.ncbi.nlm.nih.gov/?term=Ye+M&cauthor_id=42665678)[#](https://pubmed.ncbi.nlm.nih.gov/42665678/#short-view-equal-contrib-explanation "Contributed equally")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42665678/#short-view-affiliation-2 "Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China."), [Tao Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+T&cauthor_id=42665678)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42665678/#short-view-affiliation-2 "Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China."), [Mengfan Shi](https://pubmed.ncbi.nlm.nih.gov/?term=Shi+M&cauthor_id=42665678)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42665678/#short-view-affiliation-2 "Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China."), [Min Da](https://pubmed.ncbi.nlm.nih.gov/?term=Da+M&cauthor_id=42665678)[#](https://pubmed.ncbi.nlm.nih.gov/42665678/#short-view-equal-contrib-explanation "Contributed equally")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42665678/#short-view-affiliation-4 "Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China. damingirlnanjing@126.com."), [Jirong Qi](https://pubmed.ncbi.nlm.nih.gov/?term=Qi+J&cauthor_id=42665678)[#](https://pubmed.ncbi.nlm.nih.gov/42665678/#short-view-equal-contrib-explanation "Contributed equally")[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42665678/#short-view-affiliation-5 "Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China. ertongxinlianxin@163.com.")[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42665678/#short-view-affiliation-6 "Department of Cardiovascular Surgery, Qinghai University Affiliated Hospital, Xining, China. ertongxinlianxin@163.com.") ### Affiliations * 1 Clinical Medical School, Qinghai University, Xining, China. * 2 Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China. * 3 Department of Endocrinology, Genetics and Metabolism, Children's Hospital of Nanjing Medical University, Nanjing, China. * 4 Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China. damingirlnanjing@126.com. * 5 Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China. ertongxinlianxin@163.com. * 6 Department of Cardiovascular Surgery, Qinghai University Affiliated Hospital, Xining, China. ertongxinlianxin@163.com. # Contributed equally. * PMID: **42665678** * DOI: [ 10.1007/s00431-026-07365-9 ](https://doi.org/10.1007/s00431-026-07365-9) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## 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 0.05). 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. **Conclusion:** Timely 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. **Keywords:** Lobectomy; Necrotizing pneumonia; Pediatrics; Surgical treatment. © 2026. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Conflict of interest statement Declarations. Ethics approval: This study was approved by the Ethics Committee of the Children’s Hospital of Nanjing Medical University (No. 202510017–1). The trials were conducted in accordance with the tenets of the Declaration of Helsinki. The guardians of the children signed an informed consent form. Consent to participate: Written informed consent was obtained from the parent/legal guardian of participants prior to the study. Competing interests: The authors declare no competing interests. ## References 1. 1. Teresinha Mocelin H, Bueno Fischer G, Danezi Piccini J, de Oliveira EJ, Feijó Andrade C, Bush A (2024) Necrotizing pneumonia in children: a review. Paediatr Respir Rev 52:51–57 - [PubMed](https://pubmed.ncbi.nlm.nih.gov/38749797/) 2. 1. Ness-Cochinwala M, Totapally BR (2025) A comprehensive review of pediatric necrotizing pneumonia. Children (Basel). - [DOI](https://doi.org/10.3390/children12091248) - [PubMed](https://pubmed.ncbi.nlm.nih.gov/41007113/) - [PMC](https://pmc.ncbi.nlm.nih.gov/articles/12468505/) 3. 1. Chen Y, Li L, Wang C, Zhang Y, Zhou Y (2023) Necrotizing pneumonia in children: early recognition and management. J Clin Med. - [DOI](https://doi.org/10.3390/jcm12062256) - [PubMed](https://pubmed.ncbi.nlm.nih.gov/38202242/) - [PMC](https://pmc.ncbi.nlm.nih.gov/articles/10779914/) 4. 1. Luo Y, Wang Y (2023) Clinical characteristics of necrotizing pneumonia caused by different pathogens. Infect Drug Resist 16:3777–3786 - [DOI](https://doi.org/10.2147/idr.s419294) - [PubMed](https://pubmed.ncbi.nlm.nih.gov/37337573/) - [PMC](https://pmc.ncbi.nlm.nih.gov/articles/10276989/) 5. 1. Hsieh YC, Wang C-W, Lai S-H, Lai J-Y, Wong K-S, Huang Y-C, Chang K-Y, Chiu C-H, Lin T-Y (2011) Necrotizing pneumococcal pneumonia with bronchopleural fistula among children in Taiwan. Pediatr Infect Dis J 30:740–744 - [DOI](https://doi.org/10.1097/inf.0b013e31821b10c3) - [PubMed](https://pubmed.ncbi.nlm.nih.gov/21852763/) Show all 30 references ## MeSH terms * Child Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Child%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Child) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42665678/) * Child, Preschool Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Child%2C+Preschool%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Child%2C+Preschool) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42665678/) * Female Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Female%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Female) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42665678/) * Humans Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Humans%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Humans) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42665678/) * Infant Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Infant%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Infant) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42665678/) * Length of Stay / statistics & numerical data Actions * [ Search in PubM
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