Evidence map›Paper›PMID 42043561›Full record

ArticlePediatric surgery international2026

Long-term outcomes after operative versus conservative management of congenital thoracic malformations: a propensity-matched cohort study.

Sinja Lambrecht, Julia Elrod, Greta Thater, Meike Weis, Christel Weiß, Christoph Mohr, Laura Wuebken, Michaela Klinke, Johannes Boettcher, Michael Boettcher and 1 more

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Pediatric surgery international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Sinja LambrechtDepartment of Pediatric Surgery, Medical Faculty Mannheim, University Medical Center Mannheim, Heidelberg University, 68167, Mannheim, Germany.
Julia ElrodDepartment of Pediatric Surgery, Medical Faculty Mannheim, University Medical Center Mannheim, Heidelberg University, 68167, Mannheim, Germany.
Greta ThaterDepartment of Clinical Radiology and Nuclear Medicine, University Medical Center, Heidelberg University, 68167, Mannheim, Germany.
Meike WeisDepartment of Clinical Radiology and Nuclear Medicine, University Medical Center, Heidelberg University, 68167, Mannheim, Germany.
Christel WeißDepartment of Medical Statistics and Biomathematics, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Christoph MohrDepartment of Pediatric Surgery, Medical Faculty Mannheim, University Medical Center Mannheim, Heidelberg University, 68167, Mannheim, Germany.
Laura WuebkenDepartment of Pediatric Surgery, Medical Faculty Mannheim, University Medical Center Mannheim, Heidelberg University, 68167, Mannheim, Germany.
Michaela KlinkeDepartment of Pediatric Surgery, Medical Faculty Mannheim, University Medical Center Mannheim, Heidelberg University, 68167, Mannheim, Germany.
Johannes BoettcherDepartment of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany.
Michael BoettcherDepartment of Pediatric Surgery, Medical Faculty Mannheim, University Medical Center Mannheim, Heidelberg University, 68167, Mannheim, Germany.
Richard MartelDepartment of Pediatric Surgery, Medical Faculty Mannheim, University Medical Center Mannheim, Heidelberg University, 68167, Mannheim, Germany. richard.martel@medma.uni-heidelberg.de.ORCID http://orcid.org/0000-0003-4850-5246

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeManagement of asymptomatic congenital thoracic malformations (CTMs) remains controversial. Early resection may prevent infection or malignancy and promote compensatory lung growth, but its long-term impact is unclear. This study compared long-term cardiorespiratory and psychosocial outcomes after operative versus conservative management of CTMs and evaluated open versus thoracoscopic surgery.

methodsChildren with congenital pulmonary airway malformation, pulmonary sequestration, or congenital lobar emphysema treated at a tertiary center between 2000 and 2023 were identified retrospectively. Operative patients underwent open or thoracoscopic resection, while conservatively managed children were followed radiologically. Prospective follow-up included the 6-minute run, pulmonary function testing, and psychosocial assessment. Propensity score matching adjusted for gestational age, birth weight, lesion extent, prenatal intervention, and associated congenital diaphragmatic hernia.

resultsAmong 194 children (median follow-up 8.7 years), 162 underwent surgery and 32 were observed. Surgical patients showed smaller prenatal relative lung volume (51% vs. 79%, p = 0.02) and higher neonatal acuity (ICU admission 78% vs. 54%, p < 0.01). After matching, postnatal length of stay remained longer after surgery (15 vs. 6 days, p = 0.03). Thoracoscopy was associated with shorter postoperative stay, fewer complications and no mortality. Long-term fitness and quality of life were comparable between groups (p > 0.5).

conclusionSurgical management of CTMs does not impair long-term exercise capacity or psychosocial outcomes. Minimally invasive resection appears safe and may be offered as a preventive option in asymptomatic patients.

Indexed as

Conservative TreatmentPulmonary EmphysemaThoracoscopyBronchopulmonary SequestrationChildChild, PreschoolFemaleFollow-Up StudiesHumansInfantInfant, NewbornMalePropensity ScoreRespiratory Function TestsRetrospective StudiesTreatment OutcomeCPAMHybrid lesionLung functionPulmonary sequestrationQuality of life

Identifiers

PMID42043561
PMCPMC13121396

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