Document Detail


Congenital emphysema in children: Segmental lung resection as an alternative to lobectomy.
MedLine Citation:
PMID:  23414857     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: Congenital emphysema is a rare lung malformation characterized by overinflation of lung segments or lobe, together with ventilation and lung perfusion disorders. The lesion frequently causes respiratory distress in infants and may require urgent surgery. The pathogenesis is still controversial, and the usual treatment recommended is a lobectomy.
AIM: The aims of the study were to clarify the pathogenesis and relationship to vascular abnormalities and to assess the safety and efficacy of lung-sparing segmental resections.
MATERIALS AND METHODS: Retrospective review of hospital records, chest radiograph, digital subtraction angiography, and contrast-enhanced chest CT were used for diagnosis.
RESULTS: Forty-three (median age 4months, range 10days to 10years) children were diagnosed with congenital emphysema. Most were <1year of age at presentation (n=33; 77%). The predominant side affected was the left (n=24; 56%), and of these all but one had segmental (not lobar) lesions. Most of these then underwent segmental lung resection (S(1)-S(3)) with preservation of the uninvolved lingual (S(4-5)) segments preserved. A standard lobectomy was used in right-sided lesions. There was a high incidence of vascular abnormalities in association with the emphysematous segments, which may be important in its etiology. One child, referred in extremis and died before surgery could be undertaken. Otherwise, early and late results of surgery were rated as good or excellent in all patients. Longer-term follow-up of the preserved left lingual segments did not suggest any recurrence of emphysema.
CONCLUSION: Segmental resection in cases of left-sided congenital emphysema appears effective and merits further use as a lung-sparing operation.
Authors:
Daniil U Krivchenya; Eugene O Rudenko; Alexander G Dubrovin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  48     ISSN:  1531-5037     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-02-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  309-14     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 Elsevier Inc. All rights reserved.
Affiliation:
Department of Paediatric Surgery, Bogomolets National Medical University, National Children Specialized Hospital "OHMATDYT," Kyiv 01135, Ukraine.
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