25 years of surgery in patients with congenital lung malformations: the Rotterdam experience

OBJECTIVE: This single-center study aimed to evaluate surgical management of congenital lung malformations (CLM) and its associated perioperative results and short- and long-term outcomes. METHODS: We analyzed data from patients who underwent surgical treatment for CLM. Data were collected within the framework of a structured, prospective longitudinal follow-up program. Length of hospital stay, age at surgery and drain days were analyzed as perioperative outcomes. Surgical approaches and complications were also described. RESULTS: We included 80 surgically managed patients with CLM over a 25-year period. Eighty-two percent of patients who underwent resection were symptomatic, with respiratory insufficiency (45%) being the primary reason for intervention. Other symptoms were: reduced exercise tolerance, dyspnea and persistent coughing. Reoperation was needed in 2.5% of cases. Median age at intervention was 108 days (IQR 21-463 ) Surgical approaches included thoracotomy (60%), thoracoscopy (29%), embolization (4%) and other interventions (7%). Median length of postoperative hospitalization was 6 days. During their most recent follow-up visit, 21% of the cohort experienced pulmonary symptoms. CONCLUSIONS: A minority of patients with CLM underwent surgical treatment, most of whom were symptomatic. Surgery had low rates of severe complications and a short postoperative stay. Our findings underscore the importance of a long-term management approach.