Lau Chin Tung, Wong Kenneth K Y, Tam Paul
Department of Surgery, The University of Hong Kong , Queen Mary Hospital, Hong Kong, Hong Kong .
J Laparoendosc Adv Surg Tech A. 2018 May;28(5):595-598. doi: 10.1089/lap.2017.0276. Epub 2017 Nov 3.
Congenital pulmonary airway malformation (CPAM) is a major indication of lobectomy in children. Early lobectomy had been proposed for the advantage of compensatory lung growth. Despite the increasing use of thoracoscopic lobectomy its effect on postoperative lung function was still not well established in the literature. This study was therefore performed to study the result of postoperative pulmonary function test (PFT) on a medium term basis.
All patients who underwent thoracoscopic lobectomy for CPAM between 2006 and 2010 were recruited into the study. PFT was performed 5 years after the operation. Age-matched healthy individuals with similar body size were recruited for PFT as the control group. Demographic data and PFT results were extracted for statistical analysis. Test result less than 80% of predicted value was considered abnormal.
Fifteen consecutive patients were identified in the study period, 8 boys and 7 girls. The PFT was performed at a mean age of 9 years. None of the patients had respiratory symptoms. The forced vital capacity (FVC) (99.6% versus 97.0% predicted, P = .56), forced expiratory volume in 1 second (FEV1) (86.0% versus 89.1% predicted, P = .52), FEV1 to FVC ratio (96.6% versus 98.7% predicted, P = .60), total lung capacity (92.5% versus 94.5% predicted, P = .68), and alveolar volume adjusted diffusion capacity of carbon monoxide (106.4% versus 100.4% predicted, P = .35) showed no statistical difference from the control group.
Patients who underwent thoracoscopic lobectomy have normal lung function 5 years after the operation. Further study is necessary to confirm the long-term result.
先天性肺气道畸形(CPAM)是儿童肺叶切除术的主要适应证。早期肺叶切除术因有利于肺的代偿性生长而被提出。尽管胸腔镜肺叶切除术的应用日益增多,但其对术后肺功能的影响在文献中仍未得到充分证实。因此,本研究旨在对术后肺功能测试(PFT)的中期结果进行研究。
纳入2006年至2010年间因CPAM接受胸腔镜肺叶切除术的所有患者。术后5年进行PFT。招募年龄匹配、体型相似的健康个体进行PFT作为对照组。提取人口统计学数据和PFT结果进行统计分析。测试结果低于预测值的80%被认为异常。
研究期间共确定了15例连续患者,其中8例男孩和7例女孩。PFT在平均9岁时进行。所有患者均无呼吸道症状。用力肺活量(FVC)(预测值的99.6%对97.0%,P = 0.56)、第1秒用力呼气容积(FEV1)(预测值的86.0%对89.1%,P = 0.52)、FEV1与FVC比值(预测值的96.6%对98.7%,P = 0.60)、肺总量(预测值的92.5%对94.5%,P = 0.68)以及肺泡容积校正的一氧化碳弥散量(预测值的106.4%对100.4%,P = 0.35)与对照组相比无统计学差异。
接受胸腔镜肺叶切除术的患者术后5年肺功能正常。需要进一步研究以证实长期结果。