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. 2024 Feb 10;40(1):53.
doi: 10.1007/s00383-024-05635-x.

Congenital lung malformations: a nationwide survey on management aspects by the Italian Society of Pediatric Surgery

Luca Pio  1   2 , Valerio Gentilino  3 , Francesco Macchini  4 , Alberto Attilio Scarpa  5 , Roberto Lo Piccolo  6 , Andrea Conforti  7 , Alberto Ratta  8 , Riccardo Guanà  9 , Francesco Molinaro  10 , Sara Costanzo  11 , Giovanna Riccipetitoni  12   13 , Gabriele Lisi  14 , Paola Midrio  15   16 , Francesca Tocchioni  17 , Giovannii Cobellis  18 , Andrea Volpe  19 , Elisa Zolpi  20 , Anna Morandi  21 , Enrico Ciardini  22 , Claudio Vella  23 , Maria Giovanna Grella  24 , Maria Sergio  25 , Edoardo Guida  26 , Lorenzo Nanni  27 , Silvia Ceccanti  28 , Vincenzo Di Benedetto  29 , Maurizio Cheli  30 , Alfredo Garzi  31 , Maria Nobili  32 , Valeria Gabriele  33 , Giovanni Boroni  34 , Filippo Incerti  35 , Nicola Zampieri  36 , Sebastiano Cacciaguerra  37 , Pier Luca Ceccarelli  38 , Maria Escolino  39 , Vito Briganti  40 , Davide Gori  41 , Ciro Esposito  39 , Piergiorgio Gamba  19   42 , Fabrizio Gennari  9 , Alessandro Inserra  43   44 , Patrizia Dall'Igna  45   46 , Carmelo Romeo  47 , Pietro Bagolan  7   44 , Cosimo Bleve  20 , Fabio Chiarenza  20 , Francesco Morini  17 , Gloria Pelizzo  11 , Michele Torre  48
Affiliations
Free article

Congenital lung malformations: a nationwide survey on management aspects by the Italian Society of Pediatric Surgery

Luca Pio et al. Pediatr Surg Int. .
Free article

Abstract

Introduction: Over the years, congenital lung malformations (CLM) management remains a controversial topic in pediatric thoracic surgery. The Italian Society of Pediatric Surgery performed a national survey to study the current management variability among centers, trying to define national guidelines and a standardized approach of children with congenital lung malformations.

Methods: Following a National Society approval, an electronic survey including 35 items on post-natal management was designed, focusing on surgical, anesthesiology, radiology and pneumology aspects. The survey was conducted contacting all pediatric surgical units performing thoracic surgery.

Results: 39 pediatric surgery units (97.5%) participated in the study. 13 centers (33.3%) were classified as high-volume (Group A), while 26 centers (66.7%) were low volume (Group B). Variances in diagnostic imaging protocols were observed, with Group A performing fewer CT scans compared to Group B (p = 0.012). Surgical indications favored operative approaches for asymptomatic CLM and pulmonary sequestrations in both groups, while a wait-and-see approach was common for congenital lobar emphysema. Surgical timing for asymptomatic CLM differed significantly, with most high-volume centers operating on patients younger than 12 months (p = 0.02). Thoracoscopy was the preferred approach for asymptomatic CLM in most of centers, while postoperative long-term follow-up was not performed in most of the centers.

Conclusion: Thoracoscopic approach seems uniform in asymptomatic CLM patients and variable in symptomatic children. Lack of uniformity in surgical timing and preoperative imaging assessment has been identified as key areas to establish a common national pattern of care for CLM.

Keywords: CLM; CPAM; Congenital lung malformations; MIS; Pediatric thoracic surgery; Thoracoscopic surgery.

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