Surgical treatment of 60 patients with pulmonary malformations: what have we learned?
OBJECTIVE
To retrospectively analyze the medical charts of patients with pulmonary malformations submitted to surgical treatment and to investigate the clinical evolution prior to the definitive diagnosis.


METHODS
We analyzed the medical charts of patients with pulmonary malformations operated on at the São Paulo Hospital-Federal University of São Paulo/Paulista School of Medicine-from 1969 to 2004. Each medical chart was analyzed as to the following aspects: clinical profile; diagnosis; previous treatment; surgical treatment; and nosocomial complications. The inclusion criteria were having received a diagnosis of pulmonary malformation, having undergone pulmonary resection, and chart data being complete.


RESULTS
The analysis of the medical charts revealed that 60 patients diagnosed with pulmonary malformations-27 cases of bronchogenic cyst, 14 cases of congenital lobar emphysema, 10 cases of pulmonary sequestration, and 9 cases of cystic adenomatoid malformation-underwent surgery. Ages ranged from 4 days to 62 years (mean, 17.9 years). There was a predominance of males (55%). Ninety-two percent of the patients presented symptoms (mean duration: 15.37 months). Of the 60 patients undergoing surgery, 27 (45%) received preoperative home or hospital treatment with antibiotics. Regarding complications, we observed that morbidity was 23%, and mortality was 3.3%. Surgical times ranged from 1 to 8 h (mean, 3.2 h).


CONCLUSIONS
Misdiagnosis or delayed diagnosis of pulmonary malformations resulted in unnecessary treatments and hospitalizations, as well as in frequent, recurrent infectious complications. We believe that the definitive treatment is surgery, which is curative and has low morbidity and mortality rates.
Costa Júnior
Altair da Silva
Ada S
Department of Surgery, Thoracic Surgery Section, Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, Brazil. cirurgiatoracica@uol.com.br
Perfeito
João Aléssio Juliano
JA
Forte
Vicente
V
D000293:Adolescent; D000328:Adult; D000368:Aged; D001994:Bronchogenic Cyst / Q000151:congenital / Q000601:surgery; D001998:Bronchopulmonary Sequestration / Q000601:surgery; D002648:Child; D002675:Child, Preschool; 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* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy; D011184:Postoperative Period; D011656:Pulmonary Emphysema / Q000151:congenital / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult