title: The argument for operative approach to asymptomatic lung lesions.
abstract: Antenatal detection of congenital pulmonary airway malformations (CPAM) has improved immeasurably from its initial application in the 1980s and probably encompasses >80% of all such lesions. Accurate diagnosis still remains less reliable and definitive diagnosis requires detailed anatomical imaging (typically with CT scan) in the post-natal period. About 10% of all lesions will present with symptoms during the neonatal period and the choice of surgical intervention is then easy. For those that remain asymptomatic then there is still a degree of controversy about elective surgical resection. This article presents the case for elective surgery within the first year of life and aims to quantify the risks of non-intervention such as abscess, empyema, recurrent pneumonia, air-leak, and pneumothorax and various types of malignancy in such cases. The current surgical approach now includes both open muscle-sparing thoracotomy and thoracoscopic resection.
authors.affiliation: Department of Paediatric Surgery, King׳s College Hospital, Denmark Hill, London SE5 9RS, UK.
authors.forename: Rashmi
authors.initials: R
authors.lastname: Singh
authors.affiliation: Department of Paediatric Surgery, King׳s College Hospital, Denmark Hill, London SE5 9RS, UK. Electronic address: Markdav2@ntlworld.com.
authors.forename: Mark
authors.initials: M
authors.lastname: Davenport
mesh_terms: D006801:Humans; D008171:Lung Diseases / Q000151:congenital* / Q000601:surgery*; D013514:Surgical Procedures, Operative / Q000592:standards*
keywords: Bronchopulmonary sequestration thoracoscopy; CCAM; CPAM; Surgical intervention