Congenital Lung Malformations: Unresolved Issues and Unanswered Questions
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...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2019-06-01
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| Series: | Frontiers in Pediatrics |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/article/10.3389/fped.2019.00239/full |
| _version_ | 1828861967761145856 |
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| author | Federica Annunziata Andrew Bush Francesco Borgia Francesco Raimondi Silvia Montella Marco Poeta Melissa Borrelli Francesca Santamaria |
| author_facet | Federica Annunziata Andrew Bush Francesco Borgia Francesco Raimondi Silvia Montella Marco Poeta Melissa Borrelli Francesca Santamaria |
| author_sort | Federica Annunziata |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-13T03:14:30Z |
| format | Article |
| id | doaj.art-e11ec8a5796a449f860bc0ea31757145 |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-12-13T03:14:30Z |
| publishDate | 2019-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-e11ec8a5796a449f860bc0ea317571452022-12-22T00:01:32ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602019-06-01710.3389/fped.2019.00239460791Congenital Lung Malformations: Unresolved Issues and Unanswered QuestionsFederica Annunziata0Andrew Bush1Francesco Borgia2Francesco Raimondi3Silvia Montella4Marco Poeta5Melissa Borrelli6Francesca Santamaria7Division of Paediatrics, Department of Translational Medical Sciences, Federico II University, Naples, ItalyDepartment of Paediatrics and Paediatric Respiratory Medicine, Imperial College and Royal Brompton Hospital, London, United KingdomDivisions of Cardiology and Cardiothoracic Surgery, Department of Advanced Biomedical Sciences, Federico II University, Naples, ItalyDivision of Paediatrics, Department of Translational Medical Sciences, Federico II University, Naples, ItalyDivision of Paediatrics, Department of Translational Medical Sciences, Federico II University, Naples, ItalyDivision of Paediatrics, Department of Translational Medical Sciences, Federico II University, Naples, ItalyDivision of Paediatrics, Department of Translational Medical Sciences, Federico II University, Naples, ItalyDivision of Paediatrics, Department of Translational Medical Sciences, Federico II University, Naples, ItalyAdvances 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.https://www.frontiersin.org/article/10.3389/fped.2019.00239/fulllung malformationspulmonary sequestrationcongenital cystic adenomatoid malformationbronchogenic cystpostnatal managementsurgery |
| spellingShingle | Federica Annunziata Andrew Bush Francesco Borgia Francesco Raimondi Silvia Montella Marco Poeta Melissa Borrelli Francesca Santamaria Congenital Lung Malformations: Unresolved Issues and Unanswered Questions Frontiers in Pediatrics lung malformations pulmonary sequestration congenital cystic adenomatoid malformation bronchogenic cyst postnatal management surgery |
| title | Congenital Lung Malformations: Unresolved Issues and Unanswered Questions |
| title_full | Congenital Lung Malformations: Unresolved Issues and Unanswered Questions |
| title_fullStr | Congenital Lung Malformations: Unresolved Issues and Unanswered Questions |
| title_full_unstemmed | Congenital Lung Malformations: Unresolved Issues and Unanswered Questions |
| title_short | Congenital Lung Malformations: Unresolved Issues and Unanswered Questions |
| title_sort | congenital lung malformations unresolved issues and unanswered questions |
| topic | lung malformations pulmonary sequestration congenital cystic adenomatoid malformation bronchogenic cyst postnatal management surgery |
| url | https://www.frontiersin.org/article/10.3389/fped.2019.00239/full |
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