Timing of surgery and outcomes in patients with congenital pulmonary airway malformation: a national inpatient database study.

Abstract

Purpose: The timing of elective surgery for asymptomatic congenital pulmonary airway malformation (CPAM) at birth remains controversial. We aimed to describe characteristics and outcomes of patients who underwent surgery for CPAM.

Methods: We retrospectively identified patients aged < 18 years who were hospitalized for CPAM during the neonatal period and underwent surgery between July 2010 and March 2022 using the Diagnosis Procedure Combination database in Japan. We grouped eligible patients into those aged < 28 days (neonatal group) and ≥ 28 days (infant group) at surgery. Outcomes included in-hospital mortality, morbidity, duration of anesthesia, and hospital stay.

Results: We identified 105 neonates and 287 infants (including 89, 107, and 91 aged 28 days to 5 months, 6-12 months, and > 12 months, respectively). In-hospital mortality and morbidity were similar among the groups. In the infant group, duration of anesthesia was longer in those with preoperative admission due to bacterial pneumonia or who underwent thoracoscopic surgery. Infants with congenital malformation or emergency admission had longer hospital stays.

Conclusions: In-hospital mortality and morbidity were comparable among the different timings of surgery for CPAM. Preoperative bacterial pneumonia and thoracoscopic surgery could be risk factors for long duration of anesthesia but not for long hospital stay.