title: Optimal age for elective surgery of asymptomatic congenital pulmonary airway malformation: a meta-analysis.
abstract: Controversy exists on the optimal age for elective resection of asymptomatic congenital pulmonary airway malformation. Current recommendations vary widely, highlighting the overall lack of consensus. A systematic search of Embase, MEDLINE, CINAL, and CENTRAL was conducted in January 2016. Identified citations were screening independently in duplicate and consensus was required for inclusion. Results were pooled using inverse variance fixed effects meta-analysis. Meta-analysis results indicate no statistically significant differences for complications within the 3-month and 6-month age comparison groups [odds ratio (OR) 4.20, 95% confidence interval (CI) 0.78-22.77, I2= 0%; OR 2.39, 95% CI 0.63-9.11, I2= 0%, respectively]. Older patients were significantly favoured for 3-month and 6-month age comparison groups for length of hospital stay [mean difference (MD) 4.13, 95% CI 2.31-5.96, I2= 0%; MD 3.38, 95% CI 0.44-6.31, I2= 0%, respectively]. Borderline statistical significance was observed for chest tube duration in patients ≥6 months of age (MD 1.06, 95% CI 0.02-2.09, I2= 0%). No mortalities were recorded. Surgical treatment appears to be safe at all ages, with no mortalities and similar rates of complications between age groups. The included evidence was not sufficient to make a conclusive recommendation on optimal age for elective resection.
authors.affiliation: Department of Pediatric Surgery, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada.
authors.forename: Katrina J
authors.initials: KJ
authors.lastname: Sullivan
authors.affiliation: Department of Pediatric Surgery, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada.
authors.forename: Michelle
authors.initials: M
authors.lastname: Li
authors.affiliation: Department of Pediatric Surgery, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada.
authors.forename: Sarah
authors.initials: S
authors.lastname: Haworth
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Chernetsova
authors.affiliation: Department of Pediatric Surgery, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Wayne
authors.affiliation: Faculty of Medicine, University of Ottawa, 451 Smyth Rd, Ottawa, ON, K1H 8M5, Canada.
authors.forename: Jessica
authors.initials: J
authors.lastname: Kapralik
authors.affiliation: Department of Pediatric Surgery, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada.
authors.forename: Emily
authors.initials: E
authors.lastname: Chan
authors.affiliation: Department of Pediatric Surgery, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada. anasr@cheo.on.ca.|Faculty of Medicine, University of Ottawa, 451 Smyth Rd, Ottawa, ON, K1H 8M5, Canada. anasr@cheo.on.ca.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Nasr
mesh_terms: D000367:Age Factors; D017558:Elective Surgical Procedures; D006801:Humans; D008171:Lung Diseases / Q000151:congenital / Q000601:surgery*; D015619:Respiratory System Abnormalities / Q000601:surgery*
keywords: Asymptomatic; Congenital pulmonary airway malformation (CPAM); Elective resection; Evidence-based practice; Meta-analysis; Paediatric surgery