Lung resection in infants and children with pulmonary infections refractory to medical therapy.
OBJECTIVE
Pulmonary infections in children are common and often resolve with antibiotics and supportive therapy. When these infections become refractory to medical therapy or develop into an abscess, operative intervention may become necessary. This study was undertaken to review the experience with these pulmonary infections at the authors' institution.


METHODS
Charts of patients who underwent pulmonary resection for infectious causes were reviewed and their presentation, operative course, and long-term outcome analyzed.


RESULTS
Between 1975 and 1999, 21 children underwent operative resection of lung parenchyma for infection. Sixty-six percent of children previously had required hospitalization for pneumonia, and 91% had been treated previously, either as an inpatient or as an outpatient, for pneumonia. Seventy-one percent of children had an identifiable underlying comorbidity. Eighteen lobectomies were performed on 17 children with the remaining children requiring either segmentectomy or wedge resection. The median length of stay was 6 days. There were 3 minor complications and 3 deaths. At follow-up (median, 8.25 months), all surviving children had improvement of the chest x-ray, and this was paralleled by clinical improvement.


CONCLUSIONS
In children with pulmonary infection refractory to conservative medical therapy, operative resection can provide significant clinical improvement. When resection is performed, formal lobectomy often is required and yields a good outcome.
Cowles
Robert A
RA
Section of Pediatric Surgery, University of Michigan, Ann Arbor, MI, USA.
Lelli
Joseph L
JL
Takayasu
Jun
J
Coran
Arnold G
AG
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D015897:Comorbidity; D006801:Humans; D007223:Infant; D008169:Lung Abscess / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery*; D011013:Pneumonectomy / Q000379:methods*; D018410:Pneumonia, Bacterial / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery*; D013902:Radiography, Thoracic; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents