Tocchioni Francesca, Lombardi Enrico, Ghionzoli Marco, Ciardini Enrico, Noccioli Bruno, Messineo Antonio
Department of Pediatric Surgery, Meyer Children's Hospital, University of Florence, Florence, Italy.
Pediatric Pulmonary Unit, Meyer Children's Hospital, University of Florence, Florence, Italy.
J Pediatr Surg. 2017 Dec;52(12):1891-1897. doi: 10.1016/j.jpedsurg.2017.08.059. Epub 2017 Sep 6.
BACKGROUND/PURPOSE: To date, the optimal management of asymptomatic congenital lung malformations (CLMs) is still debated. There is still scant and controversial information regarding the long-term assessment of pulmonary function (PF) after lobectomy in children. The aim of this study is to evaluate PF in children who underwent lobectomy for CLM in infancy, hypothesizing that patients operated during the first year of life retain a normal lung function.
Children operated between 2005 and 2016 at our institution underwent PF evaluation through spirometry/whole-body plethysmography, forced oscillation technique, and multiple-breath inert gas wash-out.
Out of 85 patients who underwent lobectomy at a median age of 5months, 50 met the inclusion criteria, and 28 patients were tested. More than 80% of patients had normal FEV and FVC. The mean FEV, FVC, FEF values were higher in the patients operated before reaching one year of age.
The long-term outcome after lobectomy was excellent for most patients, as they retained a normal long-term PF. Therefore, for asymptomatic patients, a surgical approach before one year of age to avoid complications such as malignancy and to ensure an optimal PF catch-up could be beneficial.
III - Treatment Studies.
背景/目的：迄今为止，无症状先天性肺发育异常（CLM）的最佳管理仍存在争议。关于儿童肺叶切除术后肺功能（PF）的长期评估，目前仍缺乏且存在争议。本研究的目的是评估婴儿期因CLM接受肺叶切除术的儿童的肺功能，假设在生命的第一年接受手术的患者肺功能保持正常。
2005年至2016年在我们机构接受手术的儿童通过肺活量测定/全身体积描记法、强迫振荡技术和多次呼吸惰性气体冲洗进行肺功能评估。
在85例中位年龄为5个月接受肺叶切除术的患者中，50例符合纳入标准，28例患者接受了测试。超过80%的患者FEV和FVC正常。在一岁前接受手术的患者中，平均FEV、FVC、FEF值更高。
对于大多数患者来说，肺叶切除术后的长期结果非常好，因为他们保持了正常的长期肺功能。因此，对于无症状患者，一岁前采取手术方法以避免诸如恶性肿瘤等并发症并确保最佳的肺功能追赶可能是有益的。
III - 治疗研究。
