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Eur J Pediatr Surg 2023; 33(01): 081-084
DOI: 10.1055/a-1957-6898
Original Article

Does Timing of Resection Influence the Presence of Inflammation within Congenital Lung Malformations?

Nick Engall
1   Department of Paediatric Surgery, Royal Manchester Children's Hospital, Manchester, United Kingdom of Great Britain and Northern Ireland
,
Chitra Sethuraman
2   Department of Pediatric Histopathology, Royal Manchester Children's Hospital, Manchester, United Kingdom of Great Britain and Northern Ireland
,
David John Wilkinson
1   Department of Paediatric Surgery, Royal Manchester Children's Hospital, Manchester, United Kingdom of Great Britain and Northern Ireland
,
Nick Lansdale
1   Department of Paediatric Surgery, Royal Manchester Children's Hospital, Manchester, United Kingdom of Great Britain and Northern Ireland
3   Faculty of Biology Medicine and Health, The University of Manchester, Manchester, Manchester, United Kingdom of Great Britain and Northern Ireland
,
Robert Thomas Peters
1   Department of Paediatric Surgery, Royal Manchester Children's Hospital, Manchester, United Kingdom of Great Britain and Northern Ireland
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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


Publication History

Received: 01 June 2022

Accepted: 04 October 2022

Accepted Manuscript online:
09 October 2022

Article published online:
11 December 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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