Congenital pulmonary airway malformation (CPAM): surgical timing and prognosis. A retrospective observational study.

Ramjee Prasad; Om Purbey; Md Ali; Suni Kishore; Rohit Lal; Shubham Keshri

doi:10.51168/drssdp95

Authors

Ramjee Prasad Additional Professor, Department of Pediatric Surgery, IGIMS, Patna, Bihar, India
Om Prakash Purbey Assistant professor, Department of Pediatrics Surgery, IGIMS , Patna, Bihar, India
Md Mokarram Ali Assistant professor, Department of Pediatrics Surgery, IGIMS , Patna, Bihar, India
Suni Kishore Additional professor, Department of Pediatrics, IGIMS , Patna , Bihar, India
Rohit Lal Senior Resident, Department of Pediatrics Surgery, IGIMS, Patna Bihar, India
Shubham Keshri Senior Resident, Department of Pediatric surgery, IGIMS , Patna , Bihar, India

DOI:

https://doi.org/10.51168/drssdp95

Keywords:

Congenital pulmonary airway malformation, Surgical timing, Lobectomy, Thoracoscopy, Postoperative outcomes, Prognosis

Abstract

Background

Congenital pulmonary airway malformation is a rare congenital lung anomaly for which the optimal timing of surgical resection remains controversial. This study evaluated the association between surgical timing and postoperative outcomes.

Objective

To assess the influence of early versus delayed surgical resection on postoperative outcomes and prognosis in children with congenital pulmonary airway malformation

Methods

This retrospective observational study included 24 children who underwent surgical resection at the Department of Pediatric Surgery, Indira Gandhi Institute of Medical Sciences, Patna, from January 2023 to December 2024. Patients were categorized into early surgery (≤6 months; n=11) and delayed surgery (>6 months; n=13). Demographic, clinical, radiological, operative, postoperative, histopathological, and follow-up data were analyzed. Continuous and categorical variables were compared using appropriate statistical tests, with p<0.05 considered significant.

Results

The median age at surgery was 8 months (IQR: 4–18), and 14 (58.3%) patients were male. Antenatal diagnosis was established in 15 (62.5%) patients. Thoracoscopic lobectomy was completed in 16 (66.7%). Early surgery was associated with shorter hospital stay (5.1±1.0 vs. 7.2±1.4 days; p=0.003) and shorter chest tube duration (2.7±0.8 vs. 3.8±1.1 days; p=0.014). Postoperative complications occurred in 1 (9.1%) early-surgery patient and 4 (30.8%) delayed-surgery patients. Delayed surgery was significantly associated with postoperative complications (OR 5.21, 95% CI: 1.10–24.62; p=0.038). No mortality or recurrence was observed.

Conclusion

Early surgical resection was associated with more favorable postoperative recovery and excellent short-term prognosis.

Recommendations

Early referral and elective surgical management during infancy should be considered when clinically appropriate. Larger multicentre prospective studies with longer follow-up are recommended to establish the optimal timing of surgery.

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