Clinical and Functional Respiratory Outcomes after Surgery in a cohort of patients affected by congenital lung malformations (CLMs).

Authors’ aim was to evaluate the long-term clinical and functional respiratory outcomes in children with CLMs after surgical resection. The retrospective study enrolled 77 children diagnosed with CLMs in one centre, undergoing pulmonary resection between 2000 and 2020 and at least 1 year of pulmonary follow-up.

The most frequent diagnosis was CPAM (50.65%), followed by hybrid lesions (25.97%), lobar emphysema (11.69%), and pulmonary sequestration (5.19%).

Data of surgical treatment were available for 76/77 patients, who were therefore considered in the analysis.

Twenty-eight patients (36.4%) had symptoms before surgery; of these, 22.1% experienced dyspnoea, 7.8% experienced cough, 9% had pneumothorax and 9% had recurrent pulmonary infections. Forty-nine patients (63.6%) were asymptomatic before surgery.

Surgical treatment consisted in lobectomy in 61.3%, segmentectomy in 10.7%, pneumectomy in 5.3% and wedge resections in 22.7% of cases.

Post-surgery complications (pneumothorax and respiratory distress among the most common ones) involved 31.2% of patients. The presence of these complications was not statistically related to patient sex, the timing of the surgery (before or after 6 months of life), the surgical method involved (lobectomy, segmentectomy, or pneumonectomy), or the presence of symptoms prior to intervention.

Fifty-six out of these seventy-six patients (73.7%) experienced long-term complications, such as chronic cough (44.7%), recurrent lower-airway infections (21%), wheezing (25%), poor tolerance to exercise (10.5%), or orthopaedic complications (27.6%). Long-term complications were not statistically related to age at time of surgery, patient sex, presence of symptoms pre-intervention, type of surgery, or the presence of short-term complications after surgery.

Lung function tests have been performed in 54 of 77 children (70.1%), with a median age of 7 years. Pulmonary function tests revealed FEV1 Z scores of <-2 SDs in 16 patients, and a significant correlation between pneumonectomy and the development of lung function deficit was detected.

In conclusion, respiratory complications may occur in children with CLMs who undergo surgical resection. Therefore, a clinical and functional respiratory follow up must be considered.

Children 2022, 9, 1881. https://doi.org/10.3390/children9121881