Sureyyapasa Chest Disease and Chest Surgery Training and Research Hospital, Istanbul, Turkey.
Ann Thorac Surg. 2010 Jan;89(1):226-31. doi: 10.1016/j.athoracsur.2009.10.007.
Destroyed lung is an uncommon condition; it describes a nonfunctional lung and is most often caused by inflammatory diseases. Surgical resection is used to resolve or prevent complications and improve quality of life. We reviewed our experience in surgery for destroyed lung in children.
The records of 18 children aged 16 years and younger who had undergone pneumonectomy for destroyed lung between 1991 and 2007 were analyzed retrospectively.
Eighteen children, 10 males (55.5%) and 8 females, aged 5 to 16 years, with a mean age of 12.3 underwent pneumonectomy. Cough was the major presenting symptom (n = 18, 100%). The median preoperative period for symptoms was 6 years. Radiologic diagnostic methods included chest radiograph, computed tomography, bronchoscopy, and bronchography. Bronchiectasis (n = 13), tuberculosis (n = 4), and aspergillosis (n = 1) were the main pathologies. Five patients had tuberculosis history, and tuberculosis culture was positive in 2 patients. Pneumonectomy was applied to the left side in 14 and right side in 4 patients. There was no mortality. Complication occurred in 3 patients (atelectasis [n = 1], fistula and empyema [n = 1], and wound infection [n = 1]). Atelectasis was treated with bronchoscopy and stoma was needed for another patient for empyema. The mean follow-up was 64.9 months (range, 19 to 164 months). In their follow-up period, scoliosis was found in 1 patient.
The morbidity and mortality rates of pneumonectomy are acceptable for selected and well prepared children. Antibiotics and antituberculosis treatment in certain cases and good timing in pneumonectomy are essential. Children grew and developed normally after pneumonectomy.
损毁肺是一种不常见的情况；它描述了一个无功能的肺，并且通常是由炎症性疾病引起的。手术切除用于解决或预防并发症并提高生活质量。我们回顾了我们在儿童损毁肺手术方面的经验。
回顾性分析了 1991 年至 2007 年间 18 名年龄在 16 岁以下的儿童因损毁肺而行肺切除术的记录。
18 名儿童，男 10 例（55.5%），女 8 例，年龄 5 至 16 岁，平均年龄 12.3 岁，行肺切除术。咳嗽是主要的表现症状（18 例，100%）。症状的术前中位时间为 6 年。放射学诊断方法包括胸部 X 线、计算机断层扫描、支气管镜检查和支气管造影。支气管扩张症（13 例）、肺结核（4 例）和曲霉菌病（1 例）是主要的病理类型。5 例患者有肺结核病史，2 例患者结核培养阳性。左肺切除 14 例，右肺切除 4 例。无死亡病例。3 例患者发生并发症（肺不张[1 例]、瘘管和脓胸[1 例]、伤口感染[1 例]）。肺不张患者行支气管镜治疗，另一名患者因脓胸需要造口。平均随访时间为 64.9 个月（19 至 164 个月）。随访期间，1 例患者发现脊柱侧凸。
对于选择合适和准备充分的儿童，肺切除术的发病率和死亡率是可以接受的。某些情况下需要抗生素和抗结核治疗，以及肺切除术的良好时机至关重要。儿童在肺切除术后正常生长发育。
