Pulmonary Function After Lobectomy for Congenital Lobar Emphysema and Congenital Cystic Adenomatoid Malformation:A Follow-up Study

Abstract

Eight patients with congenital lobar emphysema and eight with congenital cystic adenomatoid malformations were operated upon between 1970 and 1978. A lobectomy was performed in all cases. At follow-up after 3 to 11 years all of the patients without concomitant disease or malformations were subjectively well with a physical performance equal to those of their playmates. Lung function tests indicated lung volumes of about 90% of predicted normal values, indicating some compensatory growth of the remaining lung tissue. Functional impairment owing to loss of lung tissue or residual disease was ruled out by the existence of a normal working capacity and maintenance of the alveolar gas exchange during intense exercise.

Congenital cystic adenomatoid malformation of the lung – The experience of five medical centres

“…A incidên-cia de MACPC foi de 1:9300 nascimentos. Onze (73%) recém-nascidos apresentaram diagnóstico pré-natal de lesão pulmonar cística pelas 22 semanas (19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30). Esta ocorreu no hemitórax direito em seis (40%) casos e no lado esquerdo em 9 (60%).…”

“…electiva é provavelmente o tratamento de escolha, mesmo nas lesões assintomáticas. 18 Após ressecção cirúrgica da lesão, a função pulmonar a longo prazo é geralmente boa, 20 apesar de anomalias minor na radiografia de tó-rax, como desvio do mediastino e hiperinsuflação lobar compensatória. A boa evolução pode ser explicada pela compensação funcional à medida que novos ácinos e alvéolos surgem até ao quinto ano de vida.…”

“…Segundo estes autores, o prognóstico pós-natal é influenciado pela severidade da dificuldade respirató-ria inicial ou no pós-operatório. A mortalidade Long term lung function is generally good following surgical excision of the lesion, 20 despite minor abnormalities in the chest CT scan such as mediastinal shift and compensatory lobar hyperinflation. Positive evolution can be explained by functional compensation, as new acini and alveoli develop until the fifth year of life.…”

Congenital Lung Lesions (CLL): Postnatal Management: Operative Intervention or Serial Observation: A Review of 2 Cases

“…Many would delay the surgery until after 2-3 months of age to decrease anaesthetic risks and the need for postoperative ventilator support [11]. Some recommend early intervention to take advantage of compensatory lung growth in early months of life [12]. The long term outcome of the LoTOS study [13] may provide answers to this ongoing debate of surgical intervention, its timing versus conservative/observation strategies.…”

Management of Congenital Lobar Emphysema: The Current Challenges

“…They may have abnormal postoperative pulmonary function tests [51], or have some compensatory growth of the remaining lung tissue which rule out functional impairment owing to loss of lung tissue or residual disease [52].…”