# Efficacy of lobectomy versus segmentectomy for congenital lung malformations: a systematic review and meta-analysis

## TL;DR

This study compares lobectomy and segmentectomy surgeries for lung malformations in children, finding similar outcomes but shorter surgery time with lobectomy.

## Contribution

The study provides a meta-analysis comparing lobectomy and segmentectomy for congenital lung malformations in pediatric patients.

## Key findings

- Lobectomy and segmentectomy showed no significant differences in hospital stay or complications.
- Lobectomy had significantly shorter operative times compared to segmentectomy.
- Pulmonary function outcomes were similar between the two surgical approaches.

## Abstract

Congenital lung malformations (CLMs) are uncommon anomalies characterized by a broad clinical spectrum, from asymptomatic cases to severe respiratory distress. Surgical resection is often indicated; nevertheless, the optimal extent of resection is still debated, especially regarding lobectomy versus lung-sparing segmentectomy.

This systematic review and meta-analysis aimed to compare the efficacy and safety of lobectomy versus segmentectomy in pediatric patients with CLMs.

We searched databases, including PubMed, Scopus, Web of Science, and Cochrane, to identify papers comparing lobectomy with segmentectomy in pediatric patients with CLMs. The main outcome was the duration of hospital stay (LOS). Secondary outcomes included operative time, chest tube removal duration, pulmonary function indices, and postoperative complications. Random-effects meta-analyses were applied.

Nine retrospective observational studies involving infants and children were included. Meta-analysis showed no significant difference in LOS between lobectomy and segmentectomy (MD − 0.20, 95% CI − 0.83 to 0.44; p = 0.547). Operative time was significantly shorter with lobectomy (MD − 18.45, 95% CI − 27.21 to − 9.68; p < 0.0001). Chest tube removal time did not differ significantly between groups. Across all pulmonary function outcomes, no statistically significant differences were observed. Overall postoperative complications were similar between procedures (OR 0.96, 95% CI 0.58–1.61; p = 0.883).

Lobectomy and segmentectomy demonstrate no differences in hospital duration, complications, or pulmonary function; nevertheless, lobectomy provides a shorter surgical time and diminished early air leakage without affecting overall postoperative results. High-quality, prospective studies are essential for clarifying long-term outcomes to improve surgical decision-making.

The online version contains supplementary material available at 10.1007/s00383-026-06362-1.