| The outcome of expectant management of congenital cystic adenomatoid malformations (CCAM) of the lung. | |
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MedLine Citation:
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PMID: 20373281 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: The appropriate management of asymptomatic congenital cystic adenomatoid malformations of the lung (CCAM) remains controversial. The aim of this study is to determine the outcome of expectant management of these lesions and the sensitivity of antenatal ultrasound diagnosis. MATERIAL AND METHODS: A retrospective review was undertaken of all cases identified from prospectively collected databases with an antenatal or postnatal diagnosis of CCAM in the Northern region of England between 1985 and 2006 where such lesions underwent resection only when symptomatic. RESULTS: Thirty-seven cases of confirmed CCAM were identified antenatally or postnatally. Twenty-six (70%) were identified by antenatal ultrasound scans (during a period of near-universal antenatal scanning), of whom 21 (81%) were liveborn. In total, 16 of 29 (55%) liveborn infants with CCAM were symptomatic, and either died within the first postnatal week or underwent resection. Thirteen (45% of livebirths) were managed expectantly and remained asymptomatic. The sensitivity of antenatal ultrasound screening for CCAM increased over the period to 90% in the latter half of the study (p=0.035), although the positive predictive value (66%) did not improve. CONCLUSIONS: Expectant management was a reasonable option for almost half of the babies, but over one third required surgery for CCAM, most becoming symptomatic in infancy. In view of the uncertainty that surrounds decisions regarding expectant or pre-emptive resection in asymptomatic infants, the authors advocate having an open and honest discussion when counselling parents (particularly antenatally) regarding surveillance or expectant management as a reasonable strategy. |
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Authors:
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P J Hammond; J M Devdas; B Ray; M Ward-Platt; A M Barrett; M McKean |
Publication Detail:
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Type: Journal Article Date: 2010-04-06 |
Journal Detail:
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Title: European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift für Kinderchirurgie Volume: 20 ISSN: 1439-359X ISO Abbreviation: Eur J Pediatr Surg Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-05-28 Completed Date: 2010-09-28 Revised Date: 2011-01-10 |
Medline Journal Info:
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Nlm Unique ID: 9105263 Medline TA: Eur J Pediatr Surg Country: Germany |
Other Details:
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Languages: eng Pagination: 145-9 Citation Subset: IM |
Affiliation:
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Royal Hospital for Sick Children, Yorkhill, Paediatric Surgery, Glasgow, United Kingdom. philiphammond@doctors.org.uk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Cystic Adenomatoid Malformation of Lung, Congenital
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surgery*,
ultrasonography* Female Humans Infant, Newborn Male Pregnancy Retrospective Studies Sensitivity and Specificity Treatment Outcome Ultrasonography, Prenatal |
| Comments/Corrections | |
Comment In:
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Eur J Pediatr Surg. 2010 Nov;20(6):412; author reply 412
[PMID:
21181606
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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