AP-HP, Hôpital Necker-Enfants Malades, Service de Pneumologie Pédiatrique, Centre de Référence pour les Maladies Respiratoires Rares de l'Enfant, Paris, France.
Paediatr Respir Rev. 2013 Sep;14(3):169-70. doi: 10.1016/j.prrv.2013.06.003. Epub 2013 Jul 12.
The need to systematically remove congenital cystic lung lesions is based on three main arguments. First, cystic malformations are often considered as congenital cystic adenomatoid malformations (CCAM), while other less favorable diagnoses are possible, such as pleuropulmonary blastoma. Only postsurgical pathological analysis allows diagnosis. Second, there are clinical and biological arguments for considering macrocystic lesions as likely to degenerate. The only prevention is surgical removal. Finally, there is no recommendation on how to follow these children, in the absence of removal, causing unnecessary family stress. This seems unjustified, compared to a feasibility of thoracoscopic removal in most cases.
有必要系统性地切除先天性肺囊性病损,主要基于三个理由。首先,囊性病损通常被认为是先天性囊性腺瘤样畸形(CCAM),但也可能存在其他预后较差的诊断,如肺胸膜胚细胞瘤。只有术后病理分析才能确诊。其次,从临床和生物学角度来看,大囊性病损有退化的可能。唯一的预防措施是手术切除。最后,在没有切除的情况下,对于这些儿童的后续处理尚无建议,这会给家庭带来不必要的压力。与大多数病例可行的胸腔镜切除相比,这种情况似乎并不合理。