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.