title: Congenital pulmonary airway malformation and sequestration: Two standpoints for a single condition.
abstract: In adults, congenital pulmonary malformations are candidates for surgery due to symptoms. A pre-natal diagnosis is simple and effective, and allows an early thoracoscopic surgical treatment. A retrospective study was performed to assess management in two different populations of adults and children to define the best strategy.
  
  
  METHODS
  Pulmonary malformations followed at the University Hospital from 2000 to 2012 were reviewed. Clinical history, malformation site, duration of hospitalisation, complications and pathology examinations were collected.
  
  
  RESULTS
  A total of 52 cases (33 children, 19 adults) were identified. In children, 28 asymptomatic cases were diagnosed pre-natally and 5 during the neonatal period due to infections. Surgery was performed on the children between the ages of 2 and 6 months. Nineteen adults underwent surgery, 16 because of symptoms and 3 adults for anomalies mimicking tumours. The mean age within the adult group was 42.5 years. In children, there was one thoracotomy and 32 thoracoscopies, with 7 conversions for difficult exposure, dissection of vascular pedicles, bleeding or bronchial injury. In the adults, there were 15 thoracotomies and 4 thoracoscopies, with one conversion. Post-operative complications in the adults were twice as frequent than in children. The mean time of the children's hospitalisation was 7.75 days versus 7.16 days for the adults. Pathological examinations showed in the children: 7 sequestrations, 18 congenital cystic pulmonary malformations (CPAM), 8 CPAM associated sequestrations; in adults: 16 sequestrations, 3 intra-pulmonary cysts.
  
  
  CONCLUSIONS
  Early thoracoscopic surgery allows pulmonary parenchyma conservation with pulmonary development, reduces respiratory and infectious complications, eliminates a false positive cancer diagnosis later in life and decreases risks of thoracic parietal deformation.
authors.affiliation: Department of Paediatric Surgery, Timone and North Children's Hospital, Aix-Marseille University and Assistance Publique-Hôpitaux de Marseille, Marseille, France.
authors.forename: Lucile
authors.initials: L
authors.lastname: Fievet
authors.affiliation: Thoracic Surgery and Diseases of the Esophagus, North Hospital, Aix-Marseille University and Assistance Publique-Hôpitaux de Marseille, Marseille, France.
authors.forename: Claudia
authors.initials: C
authors.lastname: Natale
authors.affiliation: Thoracic Surgery and Diseases of the Esophagus, North Hospital, Aix-Marseille University and Assistance Publique-Hôpitaux de Marseille, Marseille, France.
authors.forename: Xavier-Benoit
authors.initials: XB
authors.lastname: D'Journo
authors.affiliation: Department of Pediatric and Prenatal Imaging, Timone and North Hospital, Aix-Marseille University and Assistance Publique-Hôpitaux de Marseille, Marseille, France.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Coze
authors.affiliation: Department of Pediatric Pneumology, Timone and North Children's Hospital, Aix-Marseille University and Assistance Publique-Hôpitaux de Marseille, Marseille, France.
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Dubus
authors.affiliation: Department of Paediatric Surgery, Timone and North Children's Hospital, Aix-Marseille University and Assistance Publique-Hôpitaux de Marseille, Marseille, France.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Guys
authors.affiliation: Thoracic Surgery and Diseases of the Esophagus, North Hospital, Aix-Marseille University and Assistance Publique-Hôpitaux de Marseille, Marseille, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Thomas
authors.affiliation: Department of Paediatric Surgery, Timone and North Children's Hospital, Aix-Marseille University and Assistance Publique-Hôpitaux de Marseille, Marseille, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: De Lagausie
keywords: Adenomatoid malformation; antenatal; paediatric; sequestration; thoracoscopy