Abstract
Introduction Opinion remains divided on whether to resect an asymptomatic congenital lung malformation
(CLM) and on optimal timing of resection. This study aimed to determine if age at
resection of CLM correlates with the presence of histological inflammation and/or
incidence of prior antibiotic administration for lower respiratory tract infection
(LRTI).
Materials and Methods A retrospective review of all CLMs resected between 2009 and 2021 was carried out.
Data on antenatal detection, incidence of preoperative antibiotic use for LRTI, operative
details, and histological reports were analyzed. Fisher's exact test and logistic
regression were used to look for correlation between age at resection and (1) histological
inflammation and/or (2) preoperative LRTI.
Results A total of 102 patients underwent resection at age 14 months (interquartile range:
6–23). Eighty percent of children were asymptomatic in the neonatal period and 22%
of these went on to develop a respiratory symptom. In total, 59% of specimens had
histological evidence of inflammation, with a significantly higher rate of inflammation
after 10 months of age (71 vs. 35%; p = 0.0012). Logistic regression showed there was a positive correlation between age
at resection and treatment for previous LRTI (p = 0.020).
Conclusion Detection rates of inflammation in specimens resected after 10 months of age are
double the rates of those resected prior to 10 months. Delaying resection of CLMs
showed a higher frequency of treatment of LRTI. Earlier resection may therefore be
advantageous for centers pursuing a resection strategy for asymptomatic lesions.
Keywords
congenital lung malformation - inflammation - timing of resection - pediatric - infection
