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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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Children 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 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%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02) and higher neonatal acuity (ICU admission 78% vs. 54%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). After matching, postnatal length of stay remained longer after surgery (15 vs. 6 days,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03). Thoracoscopy was associated with shorter postoperative stay, fewer complications and no mortality. Long-term fitness and quality of life were comparable between groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.5).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Surgical 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00383-026-06444-0","type":"journal-article","created":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T09:21:58Z","timestamp":1777281718000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long-term outcomes after operative versus conservative management of congenital thoracic malformations: a propensity-matched cohort study"],"prefix":"10.1007","volume":"42","author":[{"given":"Sinja","family":"Lambrecht","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"Elrod","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Greta","family":"Thater","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meike","family":"Weis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christel","family":"Wei\u00df","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Mohr","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Wuebken","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michaela","family":"Klinke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johannes","family":"Boettcher","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Boettcher","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4850-5246","authenticated-orcid":false,"given":"Richard","family":"Martel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,4,27]]},"reference":[{"key":"6444_CR1","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1016\/j.jpedsurg.2016.11.014","volume":"52","author":"S Adams","year":"2017","unstructured":"Adams S, Jobson M, Sangnawakij P et al (2017) Does thoracoscopy have advantages over open surgery for asymptomatic congenital lung malformations? 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