New article you should know by Dr. Cecilia Gigena
"Clinical Symptoms Affect Treatment and Prognosis in Pediatric Patients with Congenital Pulmonary Airway Malformation: A Propensity Score Matching Retrospective Cohort Study"
Authors: Guowei Zeng, Qi Zhang, Binqian Song, Xinghui Feng, Jian Sun, Xuming Mo, Kai-Hong Wu
Full article: https://gcmd.co/3QWkNW1
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.
Type: video · 0 min · posted 2023-12-27 Canonical: https://library.globalcastmd.com/watch/clinical-symptoms-affect-treatment-and-prognosis-in-pediatric-patients-with-congenital-pulmonary-airway-malformation-7843 ## Chapters - [0:00](https://library.globalcastmd.com/watch/clinical-symptoms-affect-treatment-and-prognosis-in-pediatric-patients-with-congenital-pulmonary-airway-malformation-7843?t=0) Early Surgery for Congenital Pulmonary Airway Malformation ## Statements - "The study was retrospective and aimed to investigate safety and efficacy of surgery in asymptomatic versus symptomatic CPAM patients" — Cecilia Gigena (clinical) [0:11](https://library.globalcastmd.com/watch/clinical-symptoms-affect-treatment-and-prognosis-in-pediatric-patients-with-congenital-pulmonary-airway-malformation-7843?t=11) - "The study included 110 patients" — Cecilia Gigena (epidemiological) [0:22](https://library.globalcastmd.com/watch/clinical-symptoms-affect-treatment-and-prognosis-in-pediatric-patients-with-congenital-pulmonary-airway-malformation-7843?t=22) - "Patients who underwent surgery before becoming symptomatic had shorter length of stay" — Cecilia Gigena (clinical) [0:22](https://library.globalcastmd.com/watch/clinical-symptoms-affect-treatment-and-prognosis-in-pediatric-patients-with-congenital-pulmonary-airway-malformation-7843?t=22) - "Patients who underwent surgery before becoming symptomatic had shorter mechanical ventilation after surgery" — Cecilia Gigena (clinical) [0:22](https://library.globalcastmd.com/watch/clinical-symptoms-affect-treatment-and-prognosis-in-pediatric-patients-with-congenital-pulmonary-airway-malformation-7843?t=22) - "Patients who underwent surgery before becoming symptomatic had shorter operating times" — Cecilia Gigena (clinical) [0:22](https://library.globalcastmd.com/watch/clinical-symptoms-affect-treatment-and-prognosis-in-pediatric-patients-with-congenital-pulmonary-airway-malformation-7843?t=22) - "There was no significant difference in conversion rates between asymptomatic and symptomatic groups" — Cecilia Gigena (clinical) [0:39](https://library.globalcastmd.com/watch/clinical-symptoms-affect-treatment-and-prognosis-in-pediatric-patients-with-congenital-pulmonary-airway-malformation-7843?t=39) - "There was no significant difference in postoperative complications between asymptomatic and symptomatic groups" — Cecilia Gigena (clinical) [0:39](https://library.globalcastmd.com/watch/clinical-symptoms-affect-treatment-and-prognosis-in-pediatric-patients-with-congenital-pulmonary-airway-malformation-7843?t=39) - "It appears safer to operate on CPAM patients before they become symptomatic" — Cecilia Gigena (opinion) [0:39](https://library.globalcastmd.com/watch/clinical-symptoms-affect-treatment-and-prognosis-in-pediatric-patients-with-congenital-pulmonary-airway-malformation-7843?t=39) ## Transcript Do you wait for symptoms to treat congenital pulmonary airway malformations? Hi, I'm Cecilia Jigena from Cincinnati Children's Hospital, and I think this is an article that you should know about. This is a retrospective study that aimed to investigate the safety and efficacy for asymptomatic. Symptoms and what did they find? They had 110 patients and what they found is that patients that underwent surgery before they became symptomatic had shorter length of stay, shorter mechanic ventilation after the surgery, and shorter operating times. With no significant difference in conversion or post-op complications, so it seems that it's safer to operate these patients before they become symptomatic. Let us know what you think and stay tuned for more articles that you should know about. --- Not medical advice · citation policy: https://library.globalcastmd.com/ai