Department of Pediatric Surgery, Vanderbilt University Medical Center, Vanderbilt Children's Hospital, Nashville, TN 37232, USA.
J Pediatr Surg. 2012 Jan;47(1):87-92. doi: 10.1016/j.jpedsurg.2011.10.027.
BACKGROUND/PURPOSE: The management of asymptomatic congenital lung lesions is controversial. It is unclear whether elective resection provides a significant benefit. We sought to determine whether early vs delayed resection of asymptomatic congenital lung malformations resulted in complications.
Institutional billing records were queried for patients with lung malformations over a 10-year period. Medical records were reviewed for demographics, type of anomaly, symptoms, management, and procedural or disease-related complications.
Eighty-seven patients were identified. The diagnoses included congenital cystic adenomatoid malformation (41%), bronchogenic cyst (19.3%), sequestration (13.2%), and congenital lobar emphysema (12.0%). Fifty patients were observed for some period. Eleven became symptomatic, and 47 underwent resection at a mean age of 11 months. There was no difference in the type of resection, length of hospitalization, or complication rate between patients who underwent early vs delayed resection. There were no occurrences of malignancy or death.
In our series, there was no difference in measurable outcomes between early and delayed resection of congenital lung lesions. These data provide some support for a management strategy that might include observation with delayed resection for asymptomatic patients.
背景/目的：无症状先天性肺病变的处理存在争议。目前尚不清楚选择性切除是否能带来显著获益。我们旨在确定无症状先天性肺畸形的早期与延迟切除是否会导致并发症。
在 10 年期间，通过机构计费记录查询患有肺畸形的患者。对病历进行了回顾，以了解患者的人口统计学资料、异常类型、症状、治疗方法以及手术或疾病相关的并发症。
共确定了 87 例患者。诊断包括先天性囊性腺瘤样畸形（41%）、支气管源性囊肿（19.3%）、隔离肺（13.2%）和先天性大叶性肺气肿（12.0%）。有 50 例患者进行了一段时间的观察。有 11 例出现症状，47 例在平均 11 个月大时接受了切除手术。早期与延迟切除患者之间的切除类型、住院时间或并发症发生率没有差异。没有发生恶性肿瘤或死亡。
在我们的系列中，先天性肺病变的早期与延迟切除在可衡量的结果上没有差异。这些数据为一种治疗策略提供了一些支持，该策略可能包括对无症状患者进行延迟切除的观察。
