Optimal age for elective surgery of asymptomatic congenital pulmonary airway malformation: a meta-analysis

Pediatr Surg Int. 2017 Jun;33(6):665-675. doi: 10.1007/s00383-017-4079-2. Epub 2017 Mar 14.


Controversy exists on the optimal age for elective resection of asymptomatic congenital pulmonary airway malformation. Current recommendations vary widely, highlighting the overall lack of consensus. A systematic search of Embase, MEDLINE, CINAL, and CENTRAL was conducted in January 2016. Identified citations were screening independently in duplicate and consensus was required for inclusion. Results were pooled using inverse variance fixed effects meta-analysis. Meta-analysis results indicate no statistically significant differences for complications within the 3-month and 6-month age comparison groups [odds ratio (OR) 4.20, 95% confidence interval (CI) 0.78-22.77, I 2 = 0%; OR 2.39, 95% CI 0.63-9.11, I 2 = 0%, respectively]. Older patients were significantly favoured for 3-month and 6-month age comparison groups for length of hospital stay [mean difference (MD) 4.13, 95% CI 2.31-5.96, I 2 = 0%; MD 3.38, 95% CI 0.44-6.31, I 2 = 0%, respectively]. Borderline statistical significance was observed for chest tube duration in patients ≥6 months of age (MD 1.06, 95% CI 0.02-2.09, I 2 = 0%). No mortalities were recorded. Surgical treatment appears to be safe at all ages, with no mortalities and similar rates of complications between age groups. The included evidence was not sufficient to make a conclusive recommendation on optimal age for elective resection.

Keywords: Asymptomatic; Congenital pulmonary airway malformation (CPAM); Elective resection; Evidence-based practice; Meta-analysis; Paediatric surgery.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Age Factors
  • Elective Surgical Procedures
  • Humans
  • Lung Diseases / congenital
  • Lung Diseases / surgery*
  • Respiratory System Abnormalities / surgery*