title: Surgical intervention strategies for pediatric congenital cystic lesions of the lungs: A 20-year single-institution experience.
abstract: BACKGROUND
  The aim of this study was to assess surgical intervention strategies for congenital cystic lesions of the lungs (CCL), focusing on the safety of lung resection.
  
  
  METHODS
  The clinical features of 27 children (CCAM, n=16; bronchial atresia, n=4; bronchogenic cyst, n=3; pulmonary sequestration, n=3; lobar emphysema, n=1) who were treated at our institution between 1995 and 2014 were analyzed.
  
  
  RESULTS
  Of the 27 patients, 14 were asymptomatic, and 13 were symptomatic. The youngest symptomatic patient presented with pneumonia at 9months of age. The mean age at surgery was 4months in the asymptomatic group and 4.1years in the symptomatic group. The mean operating time was 167minutes in the asymptomatic group and 275minutes in the symptomatic group (P<0.001). The mean amount of intraoperative bleeding was 15g in the asymptomatic group and 83.4g in the symptomatic group (P<0.05). All of the prenatally diagnosed patients underwent surgery within six months of birth. Three patients had remnant cystic lesions, all of which involved cystic lesions located over the lobulation anomalies of the lung.
  
  
  CONCLUSIONS
  To minimize surgical invasiveness, surgery for CCL should be performed during the asymptomatic period or within six months after birth.
authors.affiliation: Department of Pediatric Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Taizo
authors.initials: T
authors.lastname: Furukawa
authors.affiliation: Department of Pediatric Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan. Electronic address: osamu@koto.kpu-m.ac.jp.
authors.forename: Osamu
authors.initials: O
authors.lastname: Kimura
authors.affiliation: Department of Pediatric Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Kouhei
authors.initials: K
authors.lastname: Sakai
authors.affiliation: Department of Pediatric Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Mayumi
authors.initials: M
authors.lastname: Higashi
authors.affiliation: Department of Pediatric Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Shigehisa
authors.initials: S
authors.lastname: Fumino
authors.affiliation: Department of Pediatric Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Shigeyoshi
authors.initials: S
authors.lastname: Aoi
authors.affiliation: Department of Pediatric Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Tajiri
mesh_terms: D001994:Bronchogenic Cyst / Q000151:congenital / Q000601:surgery*; D001998:Bronchopulmonary Sequestration / Q000601:surgery*; D002675:Child, Preschool; D015615:Cystic Adenomatoid Malformation of Lung, Congenital / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D061646:Operative Time; D011013:Pneumonectomy; D011656:Pulmonary Emphysema / Q000151:congenital / Q000601:surgery*; D016896:Treatment Outcome
keywords: CCAM; Minimally invasive surgery; Neonatal surgery; Operative indication