Pneumonectomy in children for destroyed lung and the long-term consequences.
OBJECTIVE
Destroyed lung introduces irreversible changes in lung parenchyma. This condition is uncommon in children. Operative intervention is essential for children in this state. We demonstrate our experience with this condition and report on the respective long-term results.


METHODS
Seventeen children who underwent pneumonectomy for destroyed lung during a 15-year period were retrospectively analyzed. Long-term results were detected in 13 patients.


RESULTS
Seventeen children underwent pneumonectomy. Five children were female (29.4%), and 12 children were male (70.5%). The median age of the study group children was 9.1 years (3-16 years). Sputum was the most common presenting symptom (n = 13, 76.4%). Bronchiectasis (n = 11), tuberculosis (n = 4), and necrotizing lung disease (n = 2) were the main underlying conditions. Destroyed lung was detected on the left side in 14 children (82.4%) and on the right side in 3 children (17.6%). Main bronchial stenosis was found in 4 children and mucosal thickening or congestion in 5 children. The median length of hospital stay was 15.5 days. The mortality rate was 11.7% (n = 2), and the morbidity rate was 23.5% (n = 4). Follow-up information was available for 13 patients, and this ranged from 1 year to 12 years (median 5.2 years). The respiratory capacity and scoliosis level of the patients were examined.


CONCLUSIONS
Although pneumonectomy is considered a difficult procedure in children, its use for destroyed lung resolves complications and improves a patient's quality of life. In time, the remaining lung expands to compensate for the loss of the removed lung. Children grew and developed normally after pneumonectomy. Patients tend not to have major skeletal deformation as the result of pneumonectomy in the short term.
Eren
Sevval
S
Department of Thoracic and Cardiovascular Surgery, Dicle University School of Medicine, 21100 Diyarbakir, Turkey. sevval@dicle.edu.tr
Eren
Mehmet Nesimi
MN
Balci
Akin Eraslan
AE
D000293:Adolescent; D001987:Bronchiectasis / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D001995:Bronchography; D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D008297:Male; D010100:Oxygen / Q000097:blood; D011013:Pneumonectomy; D011014:Pneumonia / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D011300:Preoperative Care; D012189:Retrospective Studies; D012307:Risk Factors; D013995:Time; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D014421:Turkey; D014797:Vital Capacity / Q000502:physiology
D010100:Oxygen