Exercise capacity is not decreased in children who have undergone lung resection early in life for congenital thoracic malformations compared to healthy age‐matched children

Dunn, Ashlee; Pearce, Kasey; Callister, Robin; Collison, Adam; Morten, Matthew; Mandaliya, Payal; Platt, Lauren; Dascombe, Ben J.; Kumar, Rajendra; Selvadurai, Hiran; Robinson, Paul D.; Mattes, Joërg

doi:10.1002/ppul.23772

Cited by 12 publications

(8 citation statements)

References 33 publications

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“…There is continuing debate in the literature concerning lung function outcomes in patients surgically treated for CLM. However, studies by Dunn et al and Lau et al both suggest that lobectomy for CPAMs has no detrimental effect on lung function in children, and this is in line with our results [ 38 , 39 ]. In addition, the choice of surgical approach—thoracotomy or thoracoscopy—did not lead to differences in terms of early complications, as previously reported [ 40 ], and we found no association with lung function outcome.…”

Section: Discussionsupporting

confidence: 93%

Congenital Lung Malformations: Clinical and Functional Respiratory Outcomes after Surgery

et al. 2022

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Congenital lung malformations (CLMs) involve anomalies of the lungs and respiratory tree such as congenital pulmonary airway malformation (CPAM), pulmonary sequestration (PS), bronchogenic cysts, congenital lobar emphysema, and bronchial atresia (BA). Although symptomatic lesions require surgical resection, the appropriateness of surgery for patients with asymptomatic malformations is a matter of ongoing debate. Limited data are available concerning the long-term follow-up of affected subjects. In this study, we sought to evaluate the long-term clinical and functional respiratory outcomes in children with CLMs who underwent surgical resection. We carried out a retrospective analysis of 77 children with CLMs who underwent pulmonary resection with at least one year of follow-up. The most common diagnoses were CPAM (50.65%), hybrid lesions (25.97%), lobar emphysema (11.69%), and PS (5.19%). The most common surgical approaches were lobectomy (61.3%), segmentectomy (10.7%), and pneumonectomy (5.3%). Acute post-surgery complications occurred in 31.2% of children. In addition, 73.7% experienced long-term complications, and we found no correlation between the presence of these complications and the sex of the patients, their age at time of surgery, the type of surgery undergone, the presence of symptoms prior to intervention, or acute complications after surgery. Pulmonary function tests revealed FEV1 Z-scores of <−2 SDs in 16 patients, and we found a significant correlation between pneumonectomy and the development of lung function deficit (p = 0.031). In conclusion, clinical and functional respiratory complications may occur in children with CLMs who undergo surgical resection. Long-term monitoring is needed to improve the management of asymptomatic patients.

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Section: Discussionsupporting

confidence: 93%

Congenital Lung Malformations: Clinical and Functional Respiratory Outcomes after Surgery

et al. 2022

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“…Dunn et al reported that early lung resection for congenital pulmonary malformations has no negative effects on exercise capacity later in childhood when compared to healthy age-matched controls. 26 Furthermore, according to this group the dyspnea following exercise may be due to asthma rather than residual effects of the congenital pulmonary anomaly in these children. Conversely, in a matched case-control study from Turkey, Dincel et al found that, in long-term follow-up, children surgically treated for CCAML Grade (Clavien-Dindo)…”

Section: Discussionmentioning

confidence: 95%

Respiratory and Musculoskeletal Long-Term Outcomes after Surgical Resection of Congenital Cystic Adenomatoid Malformation of the Lung in Newborns, Infants, and Toddlers

et al. 2023

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INTRODUCTION: The long-term outcomes of children who underwent surgery for Congenital Cystic Adenomatoid Malformation of the Lung (CCAML) are not well documented, particularly regarding orthopedic and respiratory follow-up (FU). The aim of this study was to assess the long-term pulmonary and orthopedic outcomes of surgically treated CCAML in newborns, infants, and toddlers. MATHERIALS AND METHODS: Retrospective examination of prospectively recorded data of consecutive patients with CCAML who underwent surgery at our tertiary referral institution from January 2000 to December 2015 (newborns, infants, and toddlers). Clinical, radiological, and surgical data, as well as FU data were revised. A multidisciplinary team followed the patients after discharge at scheduled time points. RESULTS: Seventy-seven patients were included. After surgery, patients were followed for a median of 8 years (range: 1–19years) until they reached a median age of 8 years (range: 2–19years). Thirty patients (39%) developed wheezing and 21 (27%) had lower respiratory tract infections (LRTI) within four years of age. However, more than 50% of patients with respiratory symptoms underwent complete remission in the following 4 years. Thirty-one patients (40%) developed at least one minimal musculoskeletal deformity. Eighteen (23%) had scoliosis, 17 (22%) thoracic asymmetry, 10 (12%) pectus excavatum, 5 (6%) winged scapula. CONCLUSIONS: patients operated for CCAML had good overall outcomes despite pulmonary symptoms and musculoskeletal sequelae. Even though these issues are frequently paucisymptomatic, trying to use less-invasive procedures (such as minimally axillary open "muscle-sparing" thoracotomy or thoracoscopy) may reduce this burden. A structured multidisciplinary follow-up is required.

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“…1,14 El parénquima pulmonar restante experimenta un crecimiento y desarrollo compensatorio, 47 y la función pulmonar es generalmente normal en el seguimiento a largo plazo. 14,46,[48][49][50][51][52] El buen pronóstico global descrito refleja el predominio de la lesión tipo 1. 1 Los dos casos que presentamos han tenido una evolución buena y se encuentran asintomáticos.…”

Section: Discussionunclassified

Malformación congénita de la vía aérea pulmonar tipo I: dos formas clínicas de presentación

Chong

Rodríguez

et al. 2020

Pediatr Panama

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La malformación congénita de las vías aéreas respiratorias (MCVAP), anteriormente conocida como malformación adenomatoidea quística (MAQ) es una malformación congénita poco frecuente, que forma parte de las lesiones quísticas pulmonares. Puede ser diagnosticada de manera prenatal o bien ser de presentación tardía como hallazgo casual o manifestarse por neumonías recurrentes. Se clasifica en cinco tipos en relación a condiciones anatomopatológicas y al tamaño de las lesiones. Se presentan dos casos de pacientes con malformación congénita de las vías aéreas respiratorias tipo 1 y una revisión de la literatura. En uno de los casos se realizó el diagnóstico prenatal por ecografía durante el control del embarazo y, en el otro, el diagnóstico fue tardío como hallazgo casual.

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Exercise capacity is not decreased in children who have undergone lung resection early in life for congenital thoracic malformations compared to healthy age‐matched children

Abstract: Early life lung resection for CPAM does not appear to have negative implications for exercise capacity later in childhood. Clinicians should be aware that dyspnoea following exercise may be due to asthma rather than residual effects of CPAM in these children.

Cited by 12 publications

References 33 publications

Congenital Lung Malformations: Clinical and Functional Respiratory Outcomes after Surgery

Congenital Lung Malformations: Clinical and Functional Respiratory Outcomes after Surgery

Respiratory and Musculoskeletal Long-Term Outcomes after Surgical Resection of Congenital Cystic Adenomatoid Malformation of the Lung in Newborns, Infants, and Toddlers

Malformación congénita de la vía aérea pulmonar tipo I: dos formas clínicas de presentación

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