Treatment of congenital pulmonary airway malformations: a systematic review from the APSA outcomes and evidence based practice committee

@article{Downard2017TreatmentOC,
  title={Treatment of congenital pulmonary airway malformations: a systematic review from the APSA outcomes and evidence based practice committee},
  author={Cynthia D Downard and Casey M. Calkins and Regan F. Williams and Elizabeth Renaud and Tim Jancelewicz and Julia E. Grabowski and Roshni Dasgupta and Milissa A. Mckee and Robert Baird and Mary T. Austin and Meghan A. Arnold and Adam B. Goldin and Julia S. Shelton and Saleem Islam},
  journal={Pediatric Surgery International},
  year={2017},
  volume={33},
  pages={939-953}
}
PurposeVariation in management characterizes treatment of infants with a congenital pulmonary airway malformation (CPAM. [...] Key Method English language articles published between 1960 and 2014 were compiled after searching Medline and OvidSP. The articles were divided by subject area and by the question asked, then reviewed and included if they specifically addressed the proposed question.Results1040 articles were identified on initial search.Expand
Morbidity after thoracoscopic resection of congenital pulmonary airway malformations (CPAM): single center experience over a decade
TLDR
The risks of surgery may outweigh benefit in asymptomatic children, and the surgical intervention had no impact on ‘symptomatic-P’ status.
Decision-Making Criteria for Observational Management of Congenital Pulmonary Airway Malformations (CPAMs).
TLDR
Most pediatric surgeons in Canada offer observational management to patients with asymptomatic CPAMs, and detailed imaging with a CT scan early in life to determine the morphology, size, and number of lesions guides practice.
ACTUALIZACIÓN Y CONTROVERSIAS EN EL TRATAMIENTO DE LAS MALFORMACIONES CONGÉNITAS DE LA VÍA AÉREA PULMONAR
Congenital pulmonary airway malformations (CPAM) are rare and occur due to a failure in lung embryological development. They are classified according to their pathological characteristics and their
Thoracoscopic Resection of Congenital Lung Malformation: Looking for the Right Preoperative Assessment.
  • F. Macchini, I. Borzani, +6 authors E. Leva
  • Medicine
    European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie
  • 2019
TLDR
MRI proved to be a reliable diagnostic investigation for CLM with high sensitivity and specificity and early MRI in spontaneous sleep without contrast and preoperative contrast CT scan is a valuable preoperatory assessment.
Outcomes in Children Undergoing Surgery for Congenital Pulmonary Airway Malformations in the First Year of Life.
TLDR
The data suggest that lung resection for CPAMs in the neonatal period in asymptomatic children are not associated with increased 30-day morbidity, and the presence of preoperative symptoms was independentlyassociated with increased morbidity in a multivariable regression model.
A retrospective clinical analysis of 20 cases of congenital lung masses.
  • N. Gilad, Y. Furman, A. Weissmann‐Brenner
  • Medicine
    The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
  • 2020
TLDR
Careful follow-up during pregnancy may result in term delivery of adequate-for-gestational-age newborns, with no need for admission to the NICU, with only 10% need for lobectomy during the first year of life.
Proximity to the Diaphragm Predicts the Presence of Rhabdomyomatous Dysplasia in Congenital Pulmonary Airway Malformations
TLDR
RD was seen exclusively, and in virtually all peridiaphragmatic CPAMs, and may represent incorporation of striated muscle tissue associated with the developing diaphragm.
Development of a multi-institutional registry for children with operative congenital lung malformations.
TLDR
This multicenter cohort study on operative CLMs highlights marked disease heterogeneity and substantial practice variation in preoperative evaluation and operative management in children undergoing congenital lung malformation resection.
Thoracoscopic segmentectomy for a large previously undiagnosed CPAM presenting as a spontaneous pneumothorax: A case report
TLDR
It is demonstrated that minimally invasive lung-sparing surgical treatment of a large CPAM is feasible in older children and without compromising resection margins and/or future lung function.
Thoracoscopic lobectomy through the pulmonary hilum approach for the treatment of congenital lung malformation
TLDR
An IF would certainly increase the difficulty of CLM surgery, and thoracoscopic lobectomy using the pulmonary hilum approach is an effective and safe method for CLM patients.
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References

SHOWING 1-10 OF 75 REFERENCES
Surgical versus conservative management of congenital pulmonary airway malformation in children: A systematic review and meta-analysis.
TLDR
Elective resection of asymptomatic CPAM lesions is safe and prevents the risk of symptom development, which may result in a more complicated surgery and recovery.
Lack of consensus among Canadian pediatric surgeons regarding the management of congenital cystic adenomatoid malformation of the lung.
TLDR
Lack of consensus among Canadian pediatric surgeons, and even within institutions, regarding the management of antenatally diagnosed CCAM in the asymptomatic neonate, is demonstrated and clearly highlights the need for prospective studies.
Long-term outcome of asymptomatic patients with congenital cystic adenomatoid malformation
TLDR
This study suggests patients who present with asymptomatic CCAM will subsequently become symptomatic and early surgical referral and intervention may be beneficial to avoid the development of complications.
Segmental resection for the treatment of congenital pulmonary malformations.
TLDR
Comparing clinical outcomes of segmental resection to lobectomy is compared as increasing antenatal diagnosis of congenital pulmonary malformations has led to a shift in surgical management.
Asymptomatic congenital cystic adenomatoid malformation of the lung: is it time to operate?
TLDR
Children with congenital adenomatoid malformations operated on when asymptomatic present a better short-term outcome than symptomatic children are supported, and age at the time of the operation does not negatively affect the outcome.
Systematic review and meta-analysis of the postnatal management of congenital cystic lung lesions.
TLDR
The risk of asymptomatic cases developing symptoms is small, however, elective surgery is associated with a better outcome than emergency surgery, and a conservative approach may be appropriate for small lesions.
Can congenital pulmonary airway malformation be distinguished from Type I pleuropulmonary blastoma based on clinical and radiological features?
TLDR
Clinical and radiological features can help to differentiate between Type I pleuropulmonary blastoma (PPB) and CPAM and a decision algorithm that helps to identify lesions requiring resection and those which can be safely observed is presented.
Congenital lung malformations: an ongoing controversy
TLDR
National data based on congenital anomaly registers are needed to determine the natural history of these malformations and to guide future management.
Sparing-lung surgery for the treatment of congenital lung malformations.
PURPOSE Congenital lung malformations (CLM) are traditionally treated by pulmonary lobectomy. The foremost indication for surgery is that these lesions predispose to respiratory tract infections and
Surgical management of congenital pulmonary malformations after the first decade of life.
TLDR
Early surgical management of congenital pulmonary malformations found after the first decade of life is recommended to control symptoms and avoid hospitalizations.
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