Dewan R K, Kesieme E B, Sisodia A, Ramchandani R, Kesieme C N
Department of Thoracic Surgery, LRS Institute of Tuberculosis and Respiratory Diseases, New Delhi, India.
Indian J Chest Dis Allied Sci. 2012 Apr-Jun;54(2):105-9.
To review the surgical management of congenital malformations of lung parenchyma in a thoracic surgery unit over a period of 15 years.
We carried out a retrospective analysis of records of all patients who had surgery for congenital malformations of lung parenchyma between 1995 and 2010.
Forty-five patients underwent surgery for congenital lung lesions out of 3735 thoracotomies performed during the study period. The lesions included 29 lung sequestrations, 12 bronchogenic cysts, 3 congenital lobar emphysema and one congenital cystic adenomatoid malformation. Only 26 (26%) cases were diagnosed preoperatively. Twenty-eight (62.2%) patients underwent lobectomy, 5 (11.1%) patients had pneumonectomy, and 10 (22.2%) patients had removal of cyst while 2 (0.45%) patients had lung resection with repair of the oesophageal connection. No mortality was recorded. One patient had post-operative complication of oesophageal fistula which was successfully managed conservatively. The follow-up was between 8 months to 14 years. All patients were asymptomatic and had no physical limitations during the follow-up.
Surgery is curative and produces good long-term result in patients with congenital malformations of lung parenchyma. It should be offered to patients as a therapeutic option where indicated and feasible.
回顾胸外科15年间对肺实质先天性畸形的手术治疗情况。
对1995年至2010年间所有接受肺实质先天性畸形手术患者的记录进行回顾性分析。
在研究期间进行的3735例开胸手术中，45例患者接受了先天性肺部病变手术。病变包括29例肺隔离症、12例支气管囊肿、3例先天性大叶性肺气肿和1例先天性囊性腺瘤样畸形。术前仅诊断出26例（26%）。28例（62.2%）患者接受了肺叶切除术，5例（11.1%）患者接受了全肺切除术，10例（22.2%）患者接受了囊肿切除术，2例（0.45%）患者接受了肺切除术并修复食管连接。无死亡记录。1例患者术后出现食管瘘并发症，经保守治疗成功治愈。随访时间为8个月至14年。所有患者在随访期间均无症状，无身体限制。
手术对肺实质先天性畸形患者具有治愈性，且能产生良好的长期效果。在有指征且可行的情况下，应将其作为一种治疗选择提供给患者。
