Congenital lung malformations: Do preoperative symptoms have an impact in surgical outcomes?

The management of congenital lung malformations (CLMs) is controversial because most of them are asymptomatic. The aim of our study was to analyze the association of preoperative symptoms with surgical outcomes in patients with CLMs treated by means of minimally invasive surgery (MIS).

Retrospective study of patients with CLM treated with MIS in our hospital between 2003 and 2023. We recorded data on the following variables: demographic characteristics, size, type and location of the lesion, mediastinal shift, clinical symptoms, surgical time, conversion to open surgery, duration of chest drainage (days), length of stay and postoperative complications.

The sample included 116 patients, 98 (84.4%) asymptomatic and 18 (15.5%) with clinically significant symptom: infectious in 10 (55.5%) and respiratory distress in eight. The most frequent histopathological type was congenital pulmonary airway malformation (35.5%), followed by intralobar sequestration (27.3%), and the lower lobes were most commonly involved (78.4%). Larger lesion size on the CT scan was significantly associated with the development of symptoms (P = .027) and with an increased frequency of conversion to open surgery. However, the incidence of postoperative complications was not greater in the symptomatic group.

Postoperative complications were not significantly more frequent in the symptomatic group of patients. Larger lesion size on imaging was associated with a significantly increased probability of developing symptoms, so these patients may benefit from early surgical resection.