Respiratory Morbidity Among Children Undergoing Surgical Resection for a Congenital Lung Malformation

Congenital lung malformations (CLMs) are the most common condition requiring lung surgery in children. Although surgical resection is generally well tolerated in the immediate postoperative period, long-term outcomes are not well studied. In this paper, we sought to define the risk of childhood respiratory morbidity, specifically asthma and pneumonia, in patients who underwent CLM resection.

After IRB approval, a retrospective study was conducted on all pediatric CLM resections performed at a single tertiary care children's hospital between January 2013 and December 2022. The primary outcome measures were the diagnosis of asthma and/or pneumonia more than 30 days after resection. Clinical and demographic characteristics were evaluated in univariate analysis and multivariable logistic regression as appropriate (p < 0.05).

Of the 54 patients who underwent CLM resection, 36 (67%) met inclusion criteria. The median age at resection was 6.2 months (IQR: 4.3-9.0), and the median follow-up period was 3.7 years (IQR: 1.7-5.7). Twelve were subsequently diagnosed with asthma at a median age of 3.3 years (IQR: 2.1-4.5). These observed asthma rates were significantly higher than expected when compared to nonlung surgery controls (33% vs. 6%, p < 0.01). Seven (21%) children were diagnosed with pneumonia, but this was not significantly different.

These data suggest that children undergoing lung resection for a CLM may be at an increased risk for the development of early childhood asthma. Given the potential implications for preoperative counseling and postoperative follow-up, multicenter studies to validate these findings are warranted.