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Congenital Bronchial Atresia: To Surgically Treat or Conservatively Manage? A Systematic Review

Noemi Pasqua1, Ilia Bresesti2, Salvatore Zirpoli3

  • 1Pediatric Surgery, "F. Del Ponte" Hospital, ASST Settelaghi, Varese, Italy.

Journal of Pediatric Surgery
|May 18, 2025
PubMed

Insights

Management of congenital bronchial atresia (CBA) lacks clear guidelines. Many asymptomatic patients, especially children, undergo surgery, but conservative approaches may be viable as no increased risks were found in untreated cases.

Area of Science:

  • Pulmonology
  • Pediatric Surgery
  • Thoracic Surgery

Background:

  • Congenital bronchial atresia (CBA) lacks standardized management guidelines, particularly for asymptomatic individuals.
  • This systematic review addresses both pediatric and adult CBA cases to guide future treatment strategies.

Approach:

  • A comprehensive systematic review adhering to PRISMA guidelines was performed.
  • The review included studies encompassing pediatric (<15 years) and adult (≥15 years) patients diagnosed with CBA.

Key Points:

  • Eighty-five studies involving 275 patients (169 children, 106 adults) met the inclusion criteria.
  • Surgical intervention was performed in 69.8% of cases, including 31.2% of asymptomatic patients.
  • Lobectomy was the predominant surgical procedure in pediatric CBA cases (83.8%).

Conclusions:

  • The optimal management strategy for CBA remains debated.
  • A significant percentage of asymptomatic CBA patients underwent surgical procedures, with a high prevalence of lobectomy in children.
  • Current evidence does not indicate an elevated risk of complications in untreated CBA, suggesting conservative management as a potential alternative.
Abstract

Keywords:
Congenital bronchial atresiaCongenital lung malformations

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