{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T18:11:33Z","timestamp":1779387093084,"version":"3.53.1"},"reference-count":17,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T00:00:00Z","timestamp":1778976000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background\/Objectives: The optimal timing of asymptomatic congenital pulmonary airway malformations (CPAM) is controversial. Early resection may reduce inflammation and scarring secondary to respiratory infections, but contemporary practice patterns are unknown. This study assesses trends in operative timing and approach over the past decade. Methods: A retrospective review was performed of 1934 CPAM patients in NSQIP-P undergoing resection (2012\u20132021). Trends in surgical approach and age at resection were assessed using Mann\u2013Kendall tests. Multivariable logistic and linear regression were used to model the influence of age at operation on operative length, postoperative complications, and postoperative length of stay. Results: Thoracoscopic approach increased from 47.2% in 2012 to 80.8% in 2021 (p &lt; 0.001). Median age at operation was 7.7 months. There was a downtrend in the open approach in patients \u22643 months old (tau = \u22120.511, p &lt; 0.05) without a corresponding increase in VATS approach (tau = \u22120.11, p = 0.72). Instead, there was a statistically significant uptrend in all other age cohorts &gt;3 months old in the VATS approach. After adjusting for confounders there was no difference in complication rates between age cohorts. Conclusions: Adoption of thoracoscopic resection for CPAM has substantially increased. Despite the reported benefits of earlier resection, the timing of surgical resection remains variable with most surgeries still occurring after six months of age. Additionally, the decline in open surgeries in patients \u22643 months may reflect a preference towards the VATS approach in a slightly older infant population. Further research is necessary to determine optimal timing for CPAM resection.<\/jats:p>","DOI":"10.3390\/children13050688","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T16:46:18Z","timestamp":1779381978000},"page":"688","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A 10-Year Review in the Trends in the Operative Management and Timing of Resection in Pediatric Congenital Airway Malformations: An ACS NSQIP-Pediatric Study"],"prefix":"10.3390","volume":"13","author":[{"given":"Marc M.","family":"Mankarious","sequence":"first","affiliation":[{"name":"Department of Surgery, Penn State Hershey Medical Center, Hershey, PA 17033, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicia C.","family":"Greene","sequence":"additional","affiliation":[{"name":"Department of Surgery, Penn State Hershey Medical Center, Hershey, PA 17033, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia","family":"Ziegler","sequence":"additional","affiliation":[{"name":"Department of Surgery, Penn State Hershey Medical Center, Hershey, PA 17033, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Swetha","family":"Jayavelu","sequence":"additional","affiliation":[{"name":"Department of Surgery, Penn State Hershey Medical Center, Hershey, PA 17033, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2201-4310","authenticated-orcid":false,"given":"Anthony Y.","family":"Tsai","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery, Penn State Children\u2019s Hospital, Hershey, PA 17033, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert L.","family":"Ricca","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery, Penn State Children\u2019s Hospital, Hershey, PA 17033, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afif N.","family":"Kulaylat","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery, Penn State Children\u2019s Hospital, Hershey, PA 17033, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,17]]},"reference":[{"key":"ref_1","first-page":"424","article-title":"Congenital pulmonary airway malformation: A new name and expanded classification of congenital cystic adenomatoid malformation of the lung","volume":"41","author":"Stocker","year":"2002","journal-title":"Histopathology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1007\/s00383-016-3991-1","article-title":"Is congenital pulmonary airway malformation really a rare disease? 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