Bilateral congenital lobar emphysema: staged management

Perea, Lindsey L; Blinman, Thane A.; Piccione, Joseph; Laje, Pablo

doi:10.1016/j.jpedsurg.2017.01.056

Cited by 21 publications

(34 citation statements)

References 4 publications

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“…This agreed with the literature; that the LUL is most commonly affected unilaterally followed by RUL and RML in a similar approximate percentage of anatomical distribution [8,[15][16][17]. Even though lower lobe affection and bilateral lobe affection are extremely rare and not detected in this study; they have been recorded by others [18][19][20]. The contradiction between unique studies in rates of CLOI lobes affection may be due to the distinction between the number of patients and variable duration of these studies.…”

Section: Discussionsupporting

confidence: 87%

“…Many authors reported that the classical management of CLOI is lobectomy [14,19,30,31]. Thirty-one of our cases were managed by surgical lobectomy.…”

Section: Discussionmentioning

confidence: 91%

“…Interestingly, there is a debate about CLOI management surgery versus conservative. Some authors considered the nonoperative approach in mild symptomatic cases [9,19,32]. However, regarding the extent of resection, some surgeons reported that advantages of CLOI conservative surgery by segmental lung resection rather than anatomical lobectomy [4,[33][34][35][36].…”

Section: Discussionmentioning

confidence: 99%

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Clinical and surgical aspects of congenital lobar over-inflation: a single center retrospective study

Abdel-Bary

Abdel-Naser

Okasha

et al. 2020

J Cardiothorac Surg

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Background: Congenital lobar overinflation (CLOI) is one of the most important causes of infantile respiratory distress (RD). We aim to evaluate our experience in CLOI management emphasizing on clinical features, diagnostic modalities, surgery and outcomes. Methods: This is a retrospective study for all CLOI cases undergoing surgical management at Qena University Hospital. Demographic data, clinical data, radiographic findings, surgery and postoperative follow-up were reviewed. Results: A total of 37 neonates and infants with CLOI were presented to our center between January 2015 and January 2019; their mean age was 111.43 ± 65.19 days and 22 were males. All cases presented with RD; and cyanosis in 19 cases. 15 cases presented with recurrent pneumonia and fever. Diminished breath sounds on the affected side and wheezes were the main clinical findings in 30 and 22 cases respectively. On CXR, emphysema was detected in all cases. A confirmatory CT chest was done for all cases. Left upper lobe was affected in 23 cases, right middle lobe in 7 and right upper lobe in 7 cases. Lobectomy was done in thirty-one cases; their mean age at surgery was 147.58 ± 81.49 days and 19 were males. Postoperative complications were noted in 5 cases and postoperative ventilation was required for 2 of them. No morbidity or mortality was reported. The follow-up duration ranged from 3 months to 1 year and all patients were doing well except one case that lost follow up after 3 months. Conclusion: CLOI is a rare bronchopulmonary malformation that requires a high index of clinical suspicion, especially in persistent and recurrent infantile RD. CT chest is the most useful diagnostic modality. Early management of CLOI improves outcome and avoid life-threatening complications. Surgical management is the treatment of choice in our center without recorded mortality.

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Section: Discussionsupporting

confidence: 87%

“…Many authors reported that the classical management of CLOI is lobectomy [14,19,30,31]. Thirty-one of our cases were managed by surgical lobectomy.…”

Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

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Clinical and surgical aspects of congenital lobar over-inflation: a single center retrospective study

Abdel-Bary

Abdel-Naser

Okasha

et al. 2020

J Cardiothorac Surg

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“…Lower lobe involvement (2%) is the rarest form 12–16. In the literature, more than one lobe and bilateral involvement have been described 17,18…”

Section: Epidemiologymentioning

confidence: 99%

“…In a four-patient case series, only one patient needed bilateral surgery. It was reported that three patients were prescribed one-sided lobectomy, with good survival 18. It should be kept in mind that external compression is one of the causes of the disease during surgery, and even if preoperative tests have been carried out, the surgeon should check the anatomical structures and make sure that there is no variation in the anatomy of the airway or external pressure to the airway.…”

Section: Treatmentmentioning

confidence: 99%

<p>Congenital lobar emphysema: diagnosis and treatment options</p>

Demir¹,

Hangül²,

Köse³

2019

COPD

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The long‐term outcomes of symptomatic congenital lobar emphysema patients

Gatt

Lapidus-Krol

Chiu

2023

Pediatric Pulmonology

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Introduction Surgical (OP) management for symptomatic congenital lobar emphysema (CLE) is the standard of care with nonoperative (NOP) approach applied for asymptomatic cases. The aim of this study is to report the outcomes for NOP approach to the care of symptomatic CLE infants. Methods A retrospective study of CLE patients treated 2000−2021 at a single institution. Patients with CLE and respiratory symptoms were included. Results Overall, 23 children had symptomatic CLE, and 12 had NOP management. The median age at diagnosis was 38.5 days (50) in the NOP group versus 25 days (20) in the OP group (p = 0.31). There was no significant difference in the location of the involved lobe, term birth, postnatal diagnosis and gender, and both groups required noninvasive support in 33% of the cases. There was a trend towards higher frequency of oxygen support in the OP group preoperatively (89% vs. 42%, p = 0.07). The median length of stay was 14 days in the NOP group compared to a median postsurgery stay of 7.5 days in the OP group. In follow‐up, there was no significant difference in respiratory readmission in first year of life, growth delay, treatment with asthma medication or body mass index in the NOP versus OP group. None of the children in the NOP group required surgery during follow‐up. Conclusions A NOP approach for symptomatic CLE infants can have favorable long‐term outcomes. Further studies will be required to identify markers to aid in clinical decision‐making.

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Bilateral congenital lobar emphysema: staged management

Cited by 21 publications

References 4 publications

Clinical and surgical aspects of congenital lobar over-inflation: a single center retrospective study

Clinical and surgical aspects of congenital lobar over-inflation: a single center retrospective study

<p>Congenital lobar emphysema: diagnosis and treatment options</p>

The long‐term outcomes of symptomatic congenital lobar emphysema patients

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