Three dimensional reconstruction guided anatomical regional resection versus segmentectomy for congenital pulmonary airway malformation in children.

OBJECTIVE

To compare CT-based three-dimensional (3D) reconstruction-guided anatomical regional resection with segmentectomy in children with congenital pulmonary airway malformation (CPAM).

METHODS

This single-center retrospective study included 127 children treated between July 2023 and March 2025: 59 underwent 3D-guided anatomical regional resection and 68 underwent segmentectomy. Perioperative outcomes were compared; 119 children underwent chest CT at 1 year.

RESULTS

There were no significant differences between the two groups in the characteristics related to the disease such as the type of lesion, the number of involved lung segments, the distribution of involved lung lobes, and the preoperative infection status. Regional resection was associated with shorter chest tube duration (2.2 ± 1.4 vs. 4.1 ± 1.3 days; P < 0.001) and hospital stay (5.0 ± 1.3 vs. 5.5 ± 1.4 days; P = 0.039). Operative time, postoperative complication rates, and CT findings of atelectasis or hyperinflation did not differ significantly. No residual CPAM was detected on 1-year CT in either group among the 119 children imaged.

CONCLUSION

In selected children with CPAM, 3D-guided anatomical regional resection was feasible and was associated with shorter chest tube duration and hospital stay than segmentectomy. Anatomical resection guided by ct three-dimensional reconstruction makes anatomical lesion resection and lung preservation possible in children with CPAM.