Current Controversies in the Management of Congenital Lung Malformations: A Report from the Congenital Lung Malformation Study Group
- Journal
- Journal of pediatric surgery (Q1)
- Published
- 29 September 2026
- Study design
- Unclassified
- Evidence level
- Level 5, Expert Opinion (CEBM 5)
- Authors
- Marisa E Schwab, April A Carlson, Cortnie R Vaughn, Sara L Lee, Alejandro O Chara, Emily Lake, et al.
- PMID
- 42810575
- DOI
- 10.1016/j.jpedsurg.2026.163510
Why clinicians should know about it
- Picked for Pediatric Surgery (paper of the day, 30 September 2026): Expert consensus on CLM management controversies
Abstract
BACKGROUND: There remains considerable variability in the management of congenital lung malformations (CLMs). The CLM Study Group organized a breakout session at the American Pediatric Surgical Association 2026 Annual Meeting to address current controversies in CLM care. METHODS: An expert panel of pediatric surgeons from the United States facilitated discussions on three controversial topics: 1) the role and utility of fetal MRI in the prenatal diagnostic evaluation, 2) non-operative management of asymptomatic CLMs, and 3) indocyanine green (ICG) as an emerging adjunct to enable lung-sparing resection. A live audience was polled before each discussion, and perspectives from a parent advocate with an international online following were included. RESULTS: Proponents of routine MRI cited superior lesion characterization and usefulness during prenatal counseling, but its impact on prenatal management appears to be minimal in most cases. Twenty percent (16/79) of respondents obtained an MRI in every patient whereas 48% (38/79) ordered it selectively. Resection of all CLMs, irrespective of size and subtype, had broad support for mitigating infectious and other long-term morbidities given current limitations in risk prognostication and imaging surveillance. However, 25% (18/71) of respondents reported routine non-operative management of selected asymptomatic CLMs. ICG-guided lung resection has been successfully employed, with 8% (5/63) currently using it intraoperatively. CONCLUSION: This breakout session offered a contemporary, expert-driven snapshot of practice patterns on three of the most controversial topics in the management of CLMs. Further prospective multicenter studies of these topics are warranted.
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.