Objectives
CPAM is an uncommon fetal lung anomaly characterised by the presence of
multiple cysts within the lung parenchyma due to hyperproliferation and
dilation of terminal bronchioles without normal
alveoli1. With the increasing awareness of clinicians
and the widespread use of the latest ultrasound technology, The
incidence of CPAM has increased in recent years, with an incidence of
approximately 1 in 7200 live births2, 3, and more than
90% of the lesions involved a single lobe of the
lung4. CAMP classification scheme has been revised in
2002 by Stocker and categorized them as: type 0, trachea-bronchial; type
1,bronchial/bronchiolar; type 2, bronchiolar; type 3,
bronchiolar/alveolar duct; and type 4, distal acinar5.
These cysts are connected to the normal bronchial system potentially
leading to the development of various respiratory diseases including
pneumothorax, pneumonia, hemoptysis and the development of malignancies,
and it can even lead to death6. Therefore,the surgical
intervention is very important. The appearance of these symptoms
indicates the need for immediate surgical resection, however, the
treatment plan for patients with prenatal diagnosis of CPAM who are
asymptomatic is less clear. The study by Liu Chenyu et al7found that 32% of 581 asymptomatic Congenital Lung
Malformations patients had hidden infection(HI) in postoperative
pathology, and the proportion of HI was high, which would increase the
difficulty and risk of surgery,so early surgery was advocated. Stanton
et al.8, Laberge et al.6and Esposito
et al.9recommend surgery in patients with congenital
lung malformations by the first year of life,and the consensus of
experts in China recommend surgery should be performed between 3 months
and 1 year old10, because patients who undergo early
resection are thought to experience compensatory lung growth to reduce
the risk of complication,to make the procedure technically easier and
decrease radiation exposure and related risks9,
11.However,some scholars believe that delaying surgery to later in
infancy is beneficial as older children have a decreased anaesthetic and
surgical risk12, 13.The primary objective of our
systematic review is to evaluate if age at surgical treatment of
asymptomatic paediatric CPAM patients is associated with outcomes to
determine the optimal age for surgical intervention and optimize
treatment.The primary objective of our systematic review was to assess
whether age at surgical treatment is associated with outcome in
asymptomatic pediatric CPAM patients to determine the optimal age for
surgical intervention and optimize treatment.