To Resect or to Wait in Children with Congenital Lung Lesions? A 23‑Year Propensity‑Matched Cohort Demonstrates Equivalent Long‑Term Fitness and Quality of Life

To Resect or to Wait in Children with Congenital Lung Lesions? A 23‑Year Propensity‑Matched Cohort Demonstrates Equivalent Long‑Term Fitness and Quality of Life | Authorea try { document.documentElement.classList.add('js'); } catch (e) { } var _gaq = _gaq || []; _gaq.push(['_setAccount', 'G-8VDV14Y67G']); _gaq.push(['_trackPageview']); (function() { var ga = document.createElement('script'); ga.type = 'text/javascript'; ga.async = true; ga.src = ('https:' == document.location.protocol ? 'https://ssl' : 'http://www') + '.google-analytics.com/ga.js'; var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(ga, s); })(); Skip to main content Preprints Collections Wiley Open Research IET Open Research Ecological Society of Japan All Collections About About Authorea FAQs Contact Us Quick Search anywhere Search for preprint articles, keywords, etc. Search Search ADVANCED SEARCH SCROLL This is a preprint and has not been peer reviewed. Data may be preliminary. 9 May 2025 V1 Latest version Share on To Resect or to Wait in Children with Congenital Lung Lesions? A 23‑Year Propensity‑Matched Cohort Demonstrates Equivalent Long‑Term Fitness and Quality of Life Authors : Lambrecht SR , Elrod J , Greta Thater , Weis M , Christel Weiss , Mohr C , Wuebken L , Klinke Petrowsky M , Boettcher J , Michael Boettcher , and Martel RD 0000-0003-4850-5246 [email protected] Authors Info & Affiliations https://doi.org/10.22541/au.174675963.36962672/v1 223 views 158 downloads Contents Abstract Supplementary Material Information & Authors Metrics & Citations View Options References Figures Tables Media Share Abstract Background: Congenital lung lesions (CLLs) are increasingly detected antenatally, yet the optimal management of asymptomatic cases remains debated. Early resection may forestall infection, malignant transformation and exploit compensatory lung growth, but its long‑term cost is unclear. To compare long‑term cardiorespiratory and psychosocial outcomes after operative versus conservative management of CLLs, and to contrast open with thoracoscopic surgery. Methods: All children with CPAM, pulmonary sequestration, hybrid lesions or CLE treated at a single tertiary center (2000‑2023) were retrospectively identified. Operative patients underwent open or thoracoscopic resection; conservatively managed children were followed radiologically. Prospective follow‑up included the 6‑minute‑run (6MR), spirometry/body‑plethysmography, children’s and parental psychosocial variables. Propensity‑score matching (1 : 2) adjusted for gestational age, birth‑weight, lesion extent, prenatal intervention and co‑existent CDH. Results: Among 194 children (median follow‑up 8.7 years), 162 underwent surgery (open = 120, thoracoscopy = 31) and 32 were observed. Operative patients had greater neonatal acuity (ICU admission 78 %vs. 54 %, p < 0.01) and smaller prenatal relative lung volume (51 %vs. 79 %, p = 0.02). After matching, only postnatal length of stay remained longer in the surgical group (median 15vs. 6 days, p = 0.03). Long‑term outcomes were equivalent: mean 6MR z‑score −0.46 (surgery) vs −0.43 (conservative), and children’s Quality of Life 88.7vs.89.3 (both p > 0.5). Thoracoscopy yielded shorter postoperative stay (6vs. 21 days), fewer Clavien–Dindo ≥ II complications (31 %vs. 46 %) and no deaths, without detriment to lung function. Conclusions: Surgical resection of CLLs—including thoracoscopic lobectomy or segmentectomy—does not impair long‑term exercise capacity or psychosocial well‑being when compared with observation. Given its prophylactic benefits and favorable short‑term profile, minimally invasive surgery can be offered confidently whenever technically feasible. Supplementary Material File (manuscript_cpam_2025_05_05corr.docx) Download 113.04 KB File (table1.docx) Download 19.33 KB File (table2.docx) Download 16.92 KB File (table3.docx) Download 15.20 KB File (table4.docx) Download 16.51 KB File (table5.docx) Download 14.98 KB File (table6.docx) Download 13.46 KB Information & Authors Information Version history V1 Version 1 09 May 2025 Copyright This work is licensed under a Non Exclusive No Reuse License. Keywords cpam hybrid lesion lung function pulmonary sequestration quality of life Authors Affiliations Lambrecht SR Universitat Heidelberg Medizinische Fakultat Mannheim View all articles by this author Elrod J Universitat Heidelberg Medizinische Fakultat Mannheim View all articles by this author Greta Thater Universitat Heidelberg Medizinische Fakultat Mannheim View all articles by this author Weis M Universitat Heidelberg Medizinische Fakultat Mannheim View all articles by this author Christel Weiss Universitat Heidelberg Medizinische Fakultat Mannheim View all articles by this author Mohr C Universitat Heidelberg Medizinische Fakultat Mannheim View all articles by this author Wuebken L Universitat Heidelberg Medizinische Fakultat Mannheim View all articles by this author Klinke Petrowsky M Universitat Heidelberg Medizinische Fakultat Mannheim View all articles by this author Boettcher J Universitatsklinikum Hamburg-Eppendorf Klinik fur Kinder- und Jugendpsychiatrie -psychotherapie und psychosomatik View all articles by this author Michael Boettcher Universitat Heidelberg Medizinische Fakultat Mannheim View all articles by this author Martel RD 0000-0003-4850-5246 [email protected] Universitat Heidelberg Medizinische Fakultat Mannheim View all articles by this author Metrics & Citations Metrics Article Usage 223 views 158 downloads .FvxKWukQNSOunydq8rnd { width: 100px; } Citations Download citation Lambrecht SR, Elrod J, Greta Thater, et al. To Resect or to Wait in Children with Congenital Lung Lesions? A 23‑Year Propensity‑Matched Cohort Demonstrates Equivalent Long‑Term Fitness and Quality of Life. Authorea . 09 May 2025. DOI: https://doi.org/10.22541/au.174675963.36962672/v1 If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download. For more information or tips please see 'Downloading to a citation manager' in the Help menu . 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