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

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 (2009-2021). Data on antenatal detection, the incidence of pre-operative antibiotic use for LRTI, operative details and histological reports were analysed. Fisher's exact test and logistic regression were used to look for correlation between age at resection and i) histological inflammation and/or ii) pre-operative LRTI. Results 102 patients underwent resection at age 14 months (6-23). 80% of children were asymptomatic in the neonatal period and 22% of these went on to develop a respiratory symptom. 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 centres pursuing a resection strategy for asymptomatic lesions.

DOI: 10.1055/a-1957-6898