Optimal timing for elective resection of asymptomatic congenital pulmonary airway malformations

Area of Science:

• Pediatric Surgery
• Thoracic Surgery
• Congenital Malformations

Background:

• Congenital pulmonary airway malformation (CPAM) is a rare congenital lung lesion requiring surgical management.
• Optimal timing for CPAM resection in infants remains a subject of clinical debate.

Purpose of the Study:

• To determine the optimal timing for congenital pulmonary airway malformation (CPAM) resection within the first year of life.
• To evaluate the safety and efficacy of early versus later elective CPAM resection.

Main Methods:

• A retrospective analysis of the National Surgical Quality Improvement Program pediatric database (2012-2015).
• Inclusion of 406 infants under 1 year undergoing elective CPAM resection, stratified into age groups: 1-3, 4-6, and 6-12 months.
• Comparison of operative variables and 30-day postoperative outcomes across age groups.

Main Results:

• No significant differences in demographics, comorbidities, major complications, conversion rates, or readmissions were observed between age groups.
• Median operative time increased significantly with age (115 min for 1-3 months vs. 163 min for 6-12 months, p<0.01).
• Thoracoscopic approach was less frequent in the youngest group (40.4% vs. 65.9-69.6%, p<0.01). Prolonged operative time and higher ASA class were associated with major complications.

Conclusions:

• Elective CPAM resection is equally safe across all age groups from 1 to 12 months.
• Earlier surgical intervention for CPAM is associated with reduced operative times, irrespective of surgical approach (open or thoracoscopic).