Congenital Bronchial Atresia: To Surgically Treat or Conservatively Manage? A Systematic Review

IF 2.4 2区医学 Q1 PEDIATRICS

Journal of pediatric surgery Pub Date : 2025-05-17 DOI:10.1016/j.jpedsurg.2025.162368

Noemi Pasqua , Ilia Bresesti , Salvatore Zirpoli , Michele Ghezzi , Valerio Gentilino , Federica Pederiva

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引用次数: 0

Abstract

Background

No standardized guidelines exist for the management of isolated congenital bronchial atresia (CBA), particularly in asymptomatic cases. This systematic review analyzes both pediatric and adult cases to inform future treatment recommendations.

Methods

A systematic review was conducted following PRISMA guidelines, including studies of pediatric (<15 years) and adult (≥15 years) patients with CBA.

Results

Out of 3686 screened studies, 85 met the inclusion criteria, encompassing 275 patients (169 children, 106 adults). Surgical intervention was reported in 69.8 % of cases, including 31.2 % of asymptomatic patients, with a particularly high rate of lobectomy in children (83.8 %).

Conclusions

Management of CBA remains contentious. While symptomatic are generally treated surgically, a notable proportion of asymptomatic patients also underwent surgery, with a particularly high rate of lobectomy in children. No evidence supports an increased risk of complications in untreated cases, suggesting a potential role for conservative management.

查看原文本刊更多论文

先天性支气管闭锁：手术治疗还是保守治疗？系统回顾。

背景：孤立性先天性支气管闭锁（CBA）的治疗尚无标准化的指南，特别是在无症状的病例中。本系统综述分析了儿童和成人病例，为未来的治疗建议提供信息。方法：根据PRISMA指南进行系统评价，包括儿科研究(结果：在3,686项筛选研究中，85项符合纳入标准，包括275名患者（169名儿童，106名成人）。69.8%的病例报告手术干预，其中31.2%为无症状患者，其中儿童肺叶切除术的比例特别高（83.8%）。结论：CBA的治疗仍有争议。虽然有症状的患者通常通过手术治疗，但也有相当比例的无症状患者接受手术治疗，其中儿童肺叶切除术的比例特别高。没有证据支持未经治疗的病例并发症风险增加，提示保守治疗的潜在作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of pediatric surgery 医学-外科

CiteScore

1.10

自引率

12.50%

发文量

569

审稿时长

38 days

期刊介绍： The journal presents original contributions as well as a complete international abstracts section and other special departments to provide the most current source of information and references in pediatric surgery. The journal is based on the need to improve the surgical care of infants and children, not only through advances in physiology, pathology and surgical techniques, but also by attention to the unique emotional and physical needs of the young patient.