Pulmonary resection in infants for congenital pulmonary malformation.
OBJECTIVE
To review our experience with indications, timing, and results of pulmonary resection in infants.


METHODS
Retrospective cohort study.


METHODS
Thoracic Surgery Department, Chest Diseases Hospital, Kuwait.


METHODS
Forty-seven infants with congenital lung diseases were treated with pulmonary resection from January 1993 to December 2000.


RESULTS
The mean age at the time of diagnosis was 90 days (range, 7 days to 11 months). Thirty-four patients were male (72%). Congenital lobar emphysema, congenital cystic adenomatoid malformation, pulmonary sequestration, and atelectasis were seen in 26, 10, 6, and 5 patients, respectively. The indications for surgery were respiratory distress in 32 patients (68%), respiratory tract infections in 12 patients (26%), and the presence of asymptomatic chest radiographic findings in 3 patients (6%). A lobectomy was performed in 42 patients (89%), bilobectomy in 2 patients (4%), left pneumonectomy in 1 patient (2%), and excision of a mass in 2 patients with extralobar sequestration (4%). An emergency lobectomy was performed in seven patients (15%). Only one postoperative death occurred following a left pneumonectomy for extensive congenital adenomatoid malformation due to pulmonary hypertension. Four patients (9%) had postoperative complications: atelectasis (n = 2), prolonged air leak (n = 1), and pneumothorax (n = 1). Mean follow-up was 4 years (range, 1 to 5 years) for all patients. None of the patients had any physical limitations.


CONCLUSIONS
Pulmonary resection is indicated for the majority of patients with congenital lung malformations. In case of severe respiratory distress, an emergency lobectomy can be performed safely.
Ayed
Adel K
AK
Department of Surgery, Faculty of Medicine, Kuwait University, Safat, Kuwait. Adel@hsc.kuniv.edu.kw
Owayed
Abdulla
A
D001998:Bronchopulmonary Sequestration / Q000601:surgery; D015615:Cystic Adenomatoid Malformation of Lung, Congenital / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008168:Lung / Q000002:abnormalities*; D008297:Male; D011013:Pneumonectomy; D001261:Pulmonary Atelectasis / Q000151:congenital / Q000601:surgery; D011656:Pulmonary Emphysema / Q000151:congenital / Q000601:surgery; D012189:Retrospective Studies; D013997:Time Factors