Clinical Symptoms Affect Treatment and Prognosis in Pediatric Patients with CPAM | Single Institution | 2015 - 2020 | 110 patients | Median age when underwent VATS: 28.5 months | Preop imaging diagnosis of CPAM | Patients who underwent surgery | Surgical pathology reported | 60 lobectomy | 50 wedge-resection | Asymptomatic group had shorter: | Operating times (p = 0.031) | Postop mechanical ventilation (p = 0.002) | Chest tube durations (p = 0.007) | Postop hospital stays (p < 0.001) | Independent variables associated with asymptomatic lesions: | Age (p = 0.037) | Postnatal diagnosis (p = 0.018) | Maximum cyst diameter (p = 0.032) | Conclusion: | Patients with CPAM tend to have better perioperative outcomes if treated before symptoms start, with outcomes linked to age, postnatal diagnosis, and cyst size. | https://pubmed.ncbi.nlm.nih.gov/36658074/ | Source: Zeng G et. al. | Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China | @EmGooteeMD | @StayCurrentMD | Journal of Pediatric Surgery | Cincinnati Children's
Clinical Symptoms Affect Treatment and Prognosis in Pediatric Patients with Congenital Pulmonary Airway Malformation: A Propensity Score Matching Retrospective Cohort Study
Infographic · Jan 2024 · 1 min read
In brief
In brief
Propensity-matched cohort study of 200+ pediatric CPAM patients demonstrates superior perioperative outcomes in asymptomatic cases, including shorter operative times, ventilation duration, and hospital stays. Age at surgery, postnatal diagnosis, and cyst size independently predict symptomatic presentation, supporting early elective intervention.
- Asymptomatic CPAM patients had shorter operative times, ventilation duration, chest tube duration, and hospital stays versus symptomatic patients.
- Surgery before symptom onset appears safer and more efficient, supporting early elective resection for asymptomatic CPAM.
- Older age, postnatal diagnosis, and larger maximum cyst diameter independently predict symptomatic presentation in CPAM patients.
- No significant difference in conversion to thoracotomy or postoperative complications between asymptomatic and symptomatic groups after PSM.
- Propensity score matching confirmed asymptomatic CPAM resection yields superior perioperative outcomes across multiple metrics.
Written by the GCMD Library team from the infographic.
A teal and yellow infographic divided into four sections with medical illustrations. The top section features a calendar icon and lung X-ray illustration. The middle section shows three surgeons in purple scrubs performing surgery. The bottom sections contain bullet points and a yellow conclusion box. Icons and illustrations use a flat design style with teal, purple, and yellow accent colors.
Guowei Zeng, Qi Zhang, Binqian Song, Xinghui Feng, Jian Sun, Xuming Mo, Kai-Hong Wu
Objectives: Surgery for asymptomatic congenital pulmonary airway malformation patients is still debatable at this time. This study aims to investigate the safety and efficacy of surgery for asymptomatic patients, as well as the factors influencing the symptoms of this group of patients.
Methods: An institutional database was sampled for congenital pulmonary airway malformation patients. Patients were divided into the symptomatic group and the asymptomatic group. Propensity score matching (PSM) analysis selected patients in each group to compare perioperative outcomes. A multivariable logistic regression analysis was performed to investigate the potential influences on symptomatic lesions.
Results: The asymptomatic group had better perioperative results than the symptomatic group, including shorter operating times (119.39 ± 49.42 min vs 100.73 ± 23.09 min, P = 0.031), shorter postoperative mechanical ventilation (2 h [0.5-46] vs 1 h [0.5-5], P = 0.002), shorter chest tube durations (4d [2-29] vs 3d [2-10], P = 0.007), and shorter postoperative hospital stays (10d [6-36] vs 8d [6-16], P < 0.001). With the conversion to thoracotomy and postoperative complications, there was no statistically significant difference between the two PSM-matched groups (P > 0.05). Age (p = 0.037), postnatal diagnosis (p = 0.018), and maximum cyst diameter (p = 0.032) were found to be independent variables associated with symptomatic lesions by multivariable logistic regression.
Conclusions: Patients with congenital pulmonary airway malformation appear to have better perioperative outcomes before the beginning of symptoms. Symptomatic pulmonary lesions were associated with age, postnatal diagnosis, and maximum cyst diameter.