Congenital Bronchial Atresia: To Surgically Treat or Conservatively Manage? A Systematic Review

Background: No standardized guidelines exist for the management of isolated congenital bronchial atresia (CBA), particularly in asymptomatic cases. This systematic review analyzes both pediatric and adult cases to inform future treatment recommendations. Methods: A systematic review was conducted following PRISMA guidelines, including studies of pediatric (<15 years) and adult (≥15 years) patients with CBA. Results: Out of 3686 screened studies, 85 met the inclusion criteria, encompassing 275 patients (169 children, 106 adults). Surgical intervention was reported in 69.8 % of cases, including 31.2 % of asymptomatic patients, with a particularly high rate of lobectomy in children (83.8 %). Conclusions: Management of CBA remains contentious. While symptomatic are generally treated surgically, a notable proportion of asymptomatic patients also underwent surgery, with a particularly high rate of lobectomy in children. No evidence supports an increased risk of complications in untreated cases, suggesting a potential role for conservative management.