Surgical Management of Congenital Lung Malformations: Indications, Timing, and Outcomes.

Congenital lung malformations (CLMs) represent a heterogeneous group of developmental anomalies increasingly detected through prenatal imaging. The optimal management of asymptomatic patients remains controversial. This review summarizes current evidence regarding surgical indications, timing, techniques, and outcomes. Although some studies report low rates of symptom development, longer-term data suggest that many initially asymptomatic patients eventually become symptomatic and require surgery. Delayed intervention after infection is associated with increased operative difficulty and morbidity. Additionally, the potential risk of malignant transformation, though rare, supports consideration of early resection. Minimally invasive approaches, particularly thoracoscopic surgery, have demonstrated superior postoperative recovery, musculoskeletal outcomes, and pulmonary function compared with thoracotomy. While lung-sparing procedures are increasingly utilized, careful patient selection is essential to minimize residual disease. Overall, early elective resection using minimally invasive techniques appears safe and may optimize long-term outcomes in patients with CLMs.