Association of surgery and risk of long-term comorbidities for congenital lung malformations in pediatrics
In brief
Surgery for congenital lung malformations linked to 71% fewer recurrent pneumonias
In a matched study of children with congenital lung malformations, surgery was associated with fewer recurrent pneumonias and structural deformities; asthma was lower only under a strict definition, while the main asthma analysis was not significant. Thoracoscopy was linked to fewer selected complications than open surgery, but observational data cannot establish cause or the best timing.
- Journal
- Journal of pediatric surgery (Q1)
- Published
- 23 September 2026
- Study design
- Retrospective cohort
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Wei Lee, Chun-Min Liang, Sheng-Yang Huang, Chia-Man Chou
- PMID
- 42777913
- DOI
- 10.1016/j.jpedsurg.2026.163472
Why clinicians should know about it
- Picked for Pediatric Surgery (paper of the day, 26 September 2026): Surgery timing and long‑term comorbidities for congenital lung malformations
Abstract
INTRODUCTION: Congenital lung malformations are increasingly recognized through prenatal and early postnatal imaging. Although many affected children are asymptomatic in infancy, CLMs are associated with long-term respiratory and structural complications. The influence of surgical timing, approach, and extent on these outcomes remains uncertain. MATERIALS AND METHODS: Using the TriNetX platform, we conducted a multicenter retrospective cohort study that included 20,101 children with CLM diagnosed before age 6 and 20,089,085 controls. Propensity score matching was applied. Asthma was the primary outcome, while recurrent infections and structural abnormalities were secondary outcomes. Subgroup analyses assessed the impact of surgical age, approach, and resection extent. RESULTS: While the primary asthma analysis did not reach statistical significance (RR 0.79, 95% CI 0.54-1.14, p=0.191), but statistical significance existed in asthma with strict definition (RR 0.22, 95% CI 0.11-0.42, p<0.001), recurrent pneumonia (RR 0.29, 95% CI 0.16-0.51, p< 0.001) and structural deformities (RR 0.54, 95% CI 0.30-0.97, p=0.039). Thoracoscopic surgery was associated with fewer selected complications than thoracotomy, particularly musculoskeletal outcomes. CONCLUSION: CLMs confer increased risks of respiratory and structural morbidity. The observational associations suggest that the clinical window of benefit may span the first two years of life.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.