Combined Pre- and Post-natal Minimally Invasive Approach to a Complex Symptomatic Congenital Pulmonary Airway Malformation

Congenital pulmonary airway malformation (CPAM) is a rare congenital lung lesion, that usually remains asymptomatic during the fetal and neonatal period. However, it can occasionally cause prenatal cardiocirculatory failure hydrops, requiring thoraco-amniotic shunt (TAS) placement. In other cases, also symptoms at birth (such as respiratory distress), may require urgent surgical intervention. Thoracoscopic lobectomy for neonates rarely reported. Here, we report case of right macrocystic CPAM causing hydrops 27 weeks gestation. The fetus was treated with TAS placement successfully resolved hydrops. At 39 gestation male neonate born (weight 2850g). spontaneously displaced delivery, an open pneumothorax (PNX), initially drainage. His condition gradually worsened, ventilatory support. TC scan showed different giant cysts in context lower lobe, left mediastinal shift compression rest lung. An management required. A thoracoscopic performed 10 days life 2840g). postoperative course uneventful, child remained totally good recovery. To best our knowledge this first reported iatrogenic PNX following positioning second newborn weighting less than 3kg. purpose to indicate minimally invasive surgery feasible, safe effective resection malformation, even small newborns