Congenital lung malformations: unresolved issues and unanswered questions

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Title: Congenital lung malformations: unresolved issues and unanswered questions
Authors: Annunziata, F
Bush, A
Borgia, F
Raimondi, F
Montella, S
Poeta, M
Borrelli, M
Santamaria, F
Item Type: Journal Article
Abstract: Advances in prenatal and postnatal diagnosis, perioperative management, and postoperative care have dramatically increased the number of scientific reports on congenital thoracic malformations (CTM). Nearly all CTM are detected prior to birth, generally by antenatal ultrasound. After delivery, most infants do well and remain asymptomatic for a long time. However, complications may occur beyond infancy, including in adolescence and adulthood. Prenatal diagnosis is sometimes missed and detection may occur later, either by chance or because of unexplained recurrent or persistent respiratory symptoms or signs, with difficult implications for family counseling and substantial delay in surgical planning. Although landmark studies have been published, postnatal management of asymptomatic children is still controversial and needs a resolution. Our aim is to provide a focused overview on a number of unresolved issues arising from the lack of an evidence-based consensus on the management of patients with CTM. We summarized findings from current literature, with a particular emphasis on the vigorous controversies on the type and timing of diagnostic procedures, treatments and the still obscure relationship between CTM and malignancies, a matter of great concern for both families and physicians. We also present an algorithm for the assessment and follow-up of CTM detected either in the antenatal or postnatal period. A standardized approach across Europe, based on a multidisciplinary team, is urgently needed for achieving an evidence-based management protocol for CTM.
Issue Date: 13-Jun-2019
Date of Acceptance: 28-May-2019
URI: http://hdl.handle.net/10044/1/71341
DOI: https://doi.org/10.3389/fped.2019.00239
ISSN: 2296-2360
Publisher: Frontiers Media
Journal / Book Title: Frontiers in Pediatrics
Volume: 7
Copyright Statement: © 2019 Annunziata, Bush, Borgia, Raimondi, Montella, Poeta, Borrelli and Santamaria. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Keywords: Science & Technology
Life Sciences & Biomedicine
Pediatrics
lung malformations
pulmonary sequestration
congenital cystic adenomatoid malformation
bronchogenic cyst
postnatal management
surgery
children
CYSTIC ADENOMATOID MALFORMATION
PULMONARY AIRWAY MALFORMATIONS
PRENATAL-DIAGNOSIS
POSTNATAL MANAGEMENT
BRONCHIOLOALVEOLAR CARCINOMA
THORACOSCOPIC SEGMENTECTOMY
FETAL BRONCHOSCOPY
BRONCHIAL ATRESIA
HYDROPS-FETALIS
SEQUESTRATION
bronchogenic cyst
children
congenital cystic adenomatoid malformation
lung malformations
postnatal management
pulmonary sequestration
surgery
Science & Technology
Life Sciences & Biomedicine
Pediatrics
lung malformations
pulmonary sequestration
congenital cystic adenomatoid malformation
bronchogenic cyst
postnatal management
surgery
children
CYSTIC ADENOMATOID MALFORMATION
PULMONARY AIRWAY MALFORMATIONS
PRENATAL-DIAGNOSIS
POSTNATAL MANAGEMENT
BRONCHIOLOALVEOLAR CARCINOMA
THORACOSCOPIC SEGMENTECTOMY
FETAL BRONCHOSCOPY
BRONCHIAL ATRESIA
HYDROPS-FETALIS
SEQUESTRATION
Publication Status: Published
Article Number: 239
Online Publication Date: 2019-06-13
Appears in Collections:National Heart and Lung Institute



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