Pneumonectomy in children for destroyed lung and the long-term consequences

Eren, Şevval; Eren, Mehmet Nesimi; Balcı, Akın Eraslan

doi:10.1016/s0022-5223(03)00586-5

Cited by 60 publications

(109 citation statements)

References 24 publications

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“…The lack of recognition of NP can lead to erroneous diagnoses with serious errors in management. Based on the universally favourable outcomes with conservative management, the present authors do not agree that surgical resection for the treatment of NP is necessary, as has been implied in recent publications [25][26][27], and are concerned about the use of terminology, such as 'patients required' lung resection [14] and 'destroyed lung' [26]. The role of such interventions needs to be evaluated in prospective management studies of NP.…”

Section: Summary Statistics Subjects Hospital Managementmentioning

confidence: 90%

Necrotising pneumonia is an increasingly detected complication of pneumonia in children

Sawicki¹,

Lu²,

Valim³

et al. 2008

Eur Respir J

174

171

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Necrotising pneumonia (NP) is a severe complication of community-acquired pneumonia characterised by liquefaction and cavitation of lung tissue. The present study describes the epidemiology, aetiology, management and outcomes of children hospitalised with NP over a 15-yr period. A retrospective observational study of NP cases was conducted from January 1990 to February 2005 analysing clinical presentation, laboratory data, hospital course and long-term follow-up. A total of 80 NP cases were identified, with the number of detected cases increasing from 12, in the period 1993-1996, to 40 in the period 2001-2004. In total, 69 (86%) cases had pleural effusion with a low pH (mean 7.08) and 38 (48%) patients had positive cultures, with Streptococcus pneumoniae as the predominant organism. Recently, other organisms, most notably methicillin-resistant Staphylococcus aureus, emerged. Patients had prolonged hospitalisations (median 12 days). A total of 69 patients required pleural interventions and those receiving chest drainage alone had similar outcomes to those managed surgically. All patients had full clinical resolution within 2 months of presentation. Necrotising pneumonia has increasingly been identified as a complication of paediatric pneumonia. Streptococcus pneumoniae remains the predominant organism, but since 2002, different bacteria have been isolated and the age range of cases has broadened. Despite the serious morbidity, massive parenchymal damage and prolonged hospitalisations, long-term outcome following necrotising pneumonia is excellent.

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Section: Summary Statistics Subjects Hospital Managementmentioning

confidence: 90%

Necrotising pneumonia is an increasingly detected complication of pneumonia in children

Sawicki¹,

Lu²,

Valim³

et al. 2008

Eur Respir J

174

171

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“…Preoperative routine examinations included chest X-ray, computed tomography (CT), bronchoscopy, blood count, erythrocyte sedimentation rate (ESR), coagulation tests, liver and kidney function tests, heart and pulmonary function tests, sputum TB examination, sputum tuberculosis culture, and drug sensitivity test. The hemoglobin level should be between 110 and 160 g l 1 . For male patients, the ESR should be 0-15 mm h −1 .…”

Section: Methodsmentioning

confidence: 99%

“…Surgery reduces the mortality caused by TB. However, compared to anti-TB drugs for the treatment of TB, surgery is destructive and risky [1]. With the development of effective anti-TB drugs, knowledge of lung function and anatomy, and improved surgical techniques, surgical treatment for TB has become safe, and the surgical complications and perioperative mortality rates are within an acceptable range [2,3].…”

Section: Introductionmentioning

confidence: 99%

Surgical treatment efficacy in 172 cases of tuberculosis-destroyed lungs

Bai

Hong

Gong

et al. 2011

European Journal of Cardio-Thoracic Surgery

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OBJECTIVES: Compared to the use of anti-TB drugs for the treatment of tuberculosis (TB), surgery is destructive and is associated with higher risk. Whether surgery is needed for the treatment of TB-destroyed lungs (for short: destroyed lungs) is still controversial and unresolved in the clinic. METHODS:Retrospective analysis of treatment efficacy was performed on 172 cases of destroyed lungs (176 surgeries) in the Thoracic Surgery Department of our hospital from April 1992 to June 2010. RESULTS:A total of 83 male and 89 female patients was analyzed. The youngest patient was 7 years old, and the oldest was 72 years old, with a mean age of 38.4 years. A total of 120 cases had a preoperative cough, 31 cases had fever, and 42 cases had hemoptysis. A total of 49 cases was positive for Mycobacterium tuberculosis by sputum test before surgery, yielding a positive TB rate of 28.5% (49/172). A total of 116 patients had a destroyed left lung and 56 cases had a destroyed right lung. In all, 110 cases underwent total pneumonectomy, 37 pleuropneumonectomy, one lobectomy, 10 residual lobectomy, two total pneumonectomy and tracheoplasty, 11 cases bronchopleural fistula (BPF) repair and other surgeries, and one case underwent thoracoplasty. A total of four patients underwent thoracoplasty 30 days after surgery due to a thoracic cavity infection or empyema. The overall perioperative mortality rate was 2.9% (5/172). The surgical complication rate was 18.6% (32/172). The sputum negative conversion rate was 87.8% (43/49), and the clinical cure rate was 91.9% (158/172). CONCLUSIONS:Our findings suggested that surgical treatment efficacy in destroyed lungs was satisfactory with strict surgical indications, standard preoperative anti-TB treatment, adequate preoperative preparation, and careful intraoperative operations.

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“…Bu olgularda ciddi komplikasyonların en hızlı ve etkili tedavisinin pnömonektomi olduğu kanıtlanmış-tır. 4,6,7 Çalışmamızda kronik öksürük, ateş, medikal tedaviye rağmen tekrarlayan enfeksiyonlar, pürülan balgam çıkarma, solunum sıkıntısı ve masif hemoptizi nedeniyle olgulara pnömonektomi uygulandı.…”

Section: şEkilunclassified

Pneumonectomy in destroyed lung cases

Aydın¹,

Kaynar²,

İntepe³

et al. 2012

Sakarya Med J

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ÖzetAmaç: Pulmoner enfeksiyöz hastalıklar sonucu meydana gelen yaygın akciğer destrüksiyonu için "harap akciğer" terimi kullanılmaktadır. Bu çalışmada harap akciğerli olgularda altta yatan hastalıklar, klinik özellikleri, tedavi biçimleri ve sonuçlarının literatür verileri ışığında değerlendirilmesi amaçlandı. Gereç ve Yöntem: Ocak 2000 ve Aralık 2010 yılları arasında kliniğimizde harap akciğer tanısı alıp pnömonektomi ile tedavi edilen 10 hasta geriye dönük olarak incelendi. Hastaların yaşı, cinsiyeti, altta yatan pulmoner hastalık, semptomlar, harap akciğerin lokalizasyonu, teşhisi, tedavi biçimi ve morbidite ve mortalite oranları ile hastane yatış süreleri gözden geçirildi. Bulgular: Olguların 5'i erkek, 5'i kadındı. Yaşları 11 ile 55 arasında değişmekte olup ortalama yaş 22.7 idi. Olgulardan üçünde tüberküloz tespit edildi. Harap akciğer 8 olguda sol tarafta, iki olguda sağ taraftaydı. Olgulardan sekizine sol pnömonektomi, ikisine sağ pnömonektomi uygulandı. Postoperatif bir olguda şilotoraks, bir olguda ise sekresyon stazı gözlendi. Olguların hiçbirinde mortalite gözlenmedi. Postoperatif hastane yatış süresi ortalama 12.6 (6-36 gün) gün idi. Hastaların tümünde takipte semptomlarda düzelme olduğu gözlendi. Sonuç: Harap akciğer nadir görülmesine rağmen masif hemoptizi, sekonder fungal enfeksiyonlar, sekonder amiloidozis veya pulmonersistemik şant gibi ciddi komplikasyonlara yol açabilmektedir. Yüksek morbidite ve mortalite riski bulunmasına rağmen ciddi komplikasyonlardan korunmak ve hastanın semptomlarını düzeltmek için bu olgularda mutlaka rezeksiyon gereklidir. AbstractBackground: ''Destroyed lung'' is used as a term in when there is widespread destruction of a lung occured as a result of pulmonary infectious diseases. In this study we aim to evaluate underlying diseases, clinical features, treatment modalities and results in patients of destroyed lungs in the light of literature. Material and Method: Retrospectively we reviewed 10 patients who had diagnosis of destroyed lung and treated with pneumonectomy in our clinic between January 2000 and December 2010. Patients' age, sex, underlying pulmonary disease, symptoms, localization of destroyed lung, diagnosis, treatment modality, morbidity and mortality rates and duration of hospital stay were revised. Results: 5 patients were male and 5 female. Ages was between 11 and 55 and mean age was 22.7. Tuberculosis was detected in 3 cases. Destroyed lung was on left side in 8 cases, and on right side in 2 cases. Pneumonectomy was performed on left side in 8 cases and on right side in 2 cases. Chylothorax in one case and stasis of secretion in one case was observed postoperatively. There were no mortality in any cases. Postoperative length of hospital duratin was 12.6 days in mean (6-36 days). During folllow up we observed improvements of symptoms in all patients. Conclusion: Although seeing rarely destroyed lung can cause serious complications such as massive hemoptysis, secondary fungal infections, secondary amiloidosis, and pulmonary-systemic shunt. Resection i...

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Pneumonectomy in children for destroyed lung and the long-term consequences

Cited by 60 publications

References 24 publications

Necrotising pneumonia is an increasingly detected complication of pneumonia in children

Necrotising pneumonia is an increasingly detected complication of pneumonia in children

Surgical treatment efficacy in 172 cases of tuberculosis-destroyed lungs

Pneumonectomy in destroyed lung cases

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