title: Surgical salvage of acquired lung lesions in extremely premature infants.
abstract: Acquired neonatal lung lesions including pneumatoceles, cystic bronchopulmonary dysplasia, and pulmonary interstitial emphysema can cause extrinsic mediastinal compression, which may impair pulmonary and cardiac function. Acquired lung lesions are typically managed medically. Here we report a case series of three extremely premature infants with acquired lung lesions. All three patients underwent aggressive medical management and ultimately required tube thoracostomies. These interventions were unsuccessful and emergency thoracotomies were performed in each case. Two infants with acquired pneumatoceles underwent unroofing of the cystic structure and primary repair of a bronchial defect. The third infant with pulmonary interstitial emphysema, arising from cystic bronchopulmonary dysplasia, required a middle lobectomy for severe and diffuse cystic disease. When medical management fails, tube thoracostomy can be attempted, leaving surgical intervention for refractory cases. Surgical options include oversewing a bronchial defect in the setting of a bronchopleural fistula or lung resection in cases of an isolated expanding lobe.
authors: Division of Pediatric Surgery, Department of Surgery, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, P. O. Box 709818, Los Angeles, CA, 90095-7098, USA.
authors: Greg D
authors: GD
authors: Sacks
authors: Katherine
authors: K
authors: Chung
authors: Kevin
authors: K
authors: Jamil
authors: Meena
authors: M
authors: Garg
authors: James C Y
authors: JC
authors: Dunn
authors: Daniel A
authors: DA
authors: DeUgarte
mesh_terms: D001997:Bronchopulmonary Dysplasia / Q000150:complications / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000601:surgery*; D008168:Lung / Q000601:surgery; D008171:Lung Diseases / Q000601:surgery*; D008297:Male; D011013:Pneumonectomy / Q000379:methods*; D011030:Pneumothorax / Q000601:surgery; D011656:Pulmonary Emphysema / Q000209:etiology / Q000601:surgery; D016879:Salvage Therapy / Q000379:methods*; D013908:Thoracotomy / Q000379:methods*; D016896:Treatment Outcome