Mullassery Dhanya, Jones Matthew O
Department of Pediatric Surgery, Royal Liverpool Children's Hospital, Alder Hey, Liverpool, UK L12 2AP.
J Indian Assoc Pediatr Surg. 2008 Jul;13(3):111-4. doi: 10.4103/0971-9261.43812.
Pediatric lung resection is a relatively uncommon procedure that is usually performed for congenital lesions. In recent years, thoracoscopic resection has become increasingly popular, particularly for small peripheral lesions. The aim of this study was to review our experience with traditional open lung resection in order to evaluate the existing "gold standard."
We carried out a retrospective analysis of all children having lung resection for congenital lesions at our institution between 1997 and 2004. Data were collected from analysis of case notes, operative records and clinical consultation. The mean follow-up was 37.95 months. The data were analyzed using SPSS.
Forty-one children (13 F/28 M) underwent major lung resections during the study period. Their median age was 4.66 months (1 day-9 years). The resected lesions included 21 congenital cystic adenomatoid malformations, 14 congenital lobar emphysema, four sequestrations and one bronchogenic cyst. Fifty percent of the lesions were diagnosed antenatally. Twenty-six patients had a complete lobectomy while 15 patients had parenchymal sparing resection of the lesion alone. Mean postoperative stay was 5.7 days. There have been no complications in any of the patients. All patients are currently alive, asymptomatic and well. None of the patients have any significant chest deformity.
We conclude that open lung resection enables parenchymal sparing surgery, is versatile, has few complications and produces very good long-term results. It remains the "gold standard" against which minimally invasive techniques may be judged.
小儿肺切除术是一种相对不常见的手术,通常用于治疗先天性病变。近年来,胸腔镜切除术越来越受欢迎,尤其是对于小的周边病变。本研究的目的是回顾我们在传统开放性肺切除术中的经验,以评估现有的“金标准”。
我们对1997年至2004年间在我院因先天性病变接受肺切除术的所有儿童进行了回顾性分析。数据收集自病例记录、手术记录和临床会诊分析。平均随访时间为37.95个月。使用SPSS对数据进行分析。
在研究期间,41名儿童(13名女性/28名男性)接受了主要的肺切除术。他们的中位年龄为4.66个月(1天至9岁)。切除的病变包括21例先天性囊性腺瘤样畸形、14例先天性肺叶气肿、4例肺隔离症和1例支气管囊肿。50%的病变在产前被诊断出。26例患者进行了全肺叶切除术,而15例患者仅对病变进行了保留实质的切除术。术后平均住院时间为5.7天。所有患者均无并发症。所有患者目前均存活,无症状且状况良好。没有患者有任何明显的胸部畸形。
我们得出结论,开放性肺切除术能够进行保留实质的手术,用途广泛,并发症少,并且能产生非常好的长期效果。它仍然是评判微创技术的“金标准”。