Document Detail


Chronic atelectasis of the left lower lobe: a clinicopathological condition equivalent to middle lobe syndrome.
MedLine Citation:
PMID:  22761114     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Middle lobe syndrome is a well-known clinical condition. In this retrospective study, we report our experience with a similar clinicopathological condition affecting the left lower lobe.
METHODS: The data of 17 patients with atelectasis or bronchiectasis of the left lower lobe who underwent lobectomy during the period from January 2000 to December 2011 were reviewed. Demographic, clinical, radiological and surgical data were collected.
RESULTS: Seventeen patients were included in this study, only one adult male patient of 52 years and 16 children. The paediatric patients were 10 boys and 6 girls, their age ranged from 2 to 11 years, mean 6.19 ± 2.6 years. Most patients presented with recurrent respiratory infection 15/17 (88.2%). The lag time before referral to surgery ranged from 3 to 48 months, mean 17.59 ± 13.1 months. Radiological signs of bronchiectasis were found in 11 (64.7%) patients. Bronchoscopy showed patent lower lobe bronchus in all patients. The criteria for lobectomy were evidence of bronchiectasis [11 (64.71%) patients], persistent atelectasis of the lobe after bronchoscopy and intensive medical therapy for a maximum of 2 months [6 (35.29%) patients]. Histopathological examination showed bronchiectasis in 11 (64.71%) patients, fibrosing pneumonitis in 4 (23.53%) patients and peribronchial inflammation in 2 (11.76%) patients. Most patients were doing well 1 year after surgery.
CONCLUSIONS: Chronic atelectasis of the left lower lobe is a clinicopathological condition equivalent to middle lobe syndrome. Impaired collateral ventilation together with airway plugging with secretion is an accepted explanation. Surgical resection is indicated for bronchiectatic lobe or failure of 2-month intensive medical therapy to resolve lobar atelectasis.
Authors:
Abdel-Mohsen Hamad; Elsayed Elmistekawy; Elatafy Elatafy
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Publication Detail:
Type:  Journal Article     Date:  2012-07-02
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  15     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-09-19     Completed Date:  2013-02-08     Revised Date:  2013-10-11    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  618-21     Citation Subset:  IM    
Affiliation:
Department of Cardiothoracic Surgery, University of Tanta, Tanta, Egypt. mohn_hammad@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Bronchiectasis / diagnosis,  etiology,  surgery*
Bronchoscopy
Child
Child, Preschool
Chronic Disease
Female
Humans
Male
Middle Aged
Middle Lobe Syndrome / classification,  surgery
Pneumonectomy*
Predictive Value of Tests
Pulmonary Atelectasis / classification,  diagnosis,  etiology,  surgery*
Retrospective Studies
Tomography, X-Ray Computed
Treatment Outcome
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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