Surgical versus conservative management of congenital pulmonary airway malformation in children: A systematic review and meta-analysis

Journal of Pediatric Surgery
Jessica KapralikAhmed Nasr

Abstract

The ideal management of infants born with asymptomatic congenital pulmonary airway malformation (CPAM) is controversial. We performed a systematic review and meta-analysis comparing elective resection versus expectant management. We searched CENTRAL, MEDLINE, EMBASE, CINAHL, and PubMed for studies describing the management of asymptomatic CPAM and reporting on postoperative morbidity, mortality, and length of hospital stay (LOS). We performed meta-analyses when possible and provide a narrative summary of results. One nonrandomized prospective and eight retrospective studies met our inclusion criteria. Out of 168 patients, 70 underwent surgery before symptoms developed with seven experiencing postoperative complications (10.0%); 63 developed symptoms while being managed expectantly and subsequently underwent surgery with 20 complications (31.8%). Thirty-five patients continued to be followed nonsurgically (three months to nine years of follow-up). Morbidity was higher with surgery after symptom development (6 studies; odds ratio 4.59, 95% confidence interval (CI) 1.40 to 15.11, P<0.01); there was no difference in LOS (3 studies; mean difference 4.96, 95% CI -1.75 to 11.67, P=0.15). There were no related deaths. Elective resectio...Continue Reading

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Citations

Nov 22, 2016·Ultrasound : Journal of the British Medical Ultrasound Society·Mehmet Emin Adin
Oct 20, 2017·European Journal of Pediatrics·Claire LeblancSabine Irtan
Dec 22, 2017·The American Journal of Surgical Pathology·Jennifer PogorilerWilliam Peranteau
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Apr 11, 2018·Pediatric Surgery International·Navot KantorAhmed Nasr
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Jun 30, 2019·Frontiers in Pediatrics·Federica AnnunziataFrancesca Santamaria
Mar 16, 2017·Pediatric Surgery International·Katrina J SullivanAhmed Nasr
Oct 7, 2019·European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery ... [et Al] = Zeitschrift Für Kinderchirurgie·Francesco MacchiniErnesto Leva
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Dec 19, 2017·Archivos de bronconeumología·Carmen Thais Lovera de FerreiraMaría Montserrat Bosque García

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