Shirota Chiyoe, Tainaka Takahisa, Nakane Toshiki, Tanaka Yujiro, Hinoki Akinari, Sumida Wataru, Murase Naruhiko, Oshima Kazuo, Chiba Kosuke, Shirotsuki Ryo, Uchida Hiroo
Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
BMC Pediatr. 2018 Mar 8;18(1):105. doi: 10.1186/s12887-018-1085-z.
Emergency rescue lung resection is rarely performed to treat congenital lung cysts (CLCs) in neonates. Many reports have described fetal CLC treatment; however, prenatal predictors for postnatal respiratory failure have not been characterized. We hypothesized that fetal imaging findings are useful predictors of emergency surgery.
We retrospectively studied patients with CLC who underwent lung surgery during the neonatal period in our hospital between January 2001 and December 2015. The demographic data, fetal imaging findings, and intra- and postoperative courses of patients who underwent emergency surgery (Em group) were compared with those of patients who received elective surgery, i.e., non-emergency surgery (Ne group).
The Em group and Ne group included 7 and 11 patients, respectively. No significant difference was noted in gestational age, time at prenatal diagnosis, birth weight, and body weight at surgery. The volumes of contralateral lung per thoracic volume were significantly smaller in the Em group than in the Ne group (p = 0.0188). Mediastinal compression was more common in the Em group (7/7) than in the Ne group (4/11) (p = 0.0128).
This is the report describing neonatal emergency lobectomy in patients with CLC evaluated by fetal MRI using the lung volume ratio and mediastinal shift. In patients with CLC, mediastinal shift and significant decreases in contralateral lung volumes during the fetal stages are good prenatal predictors of postnatal emergency lung resection.
急诊抢救性肺切除术很少用于治疗新生儿先天性肺囊肿（CLC）。许多报告描述了胎儿CLC的治疗；然而，出生后呼吸衰竭的产前预测因素尚未明确。我们假设胎儿影像学表现是急诊手术的有用预测指标。
我们回顾性研究了2001年1月至2015年12月期间在我院新生儿期接受肺手术的CLC患者。将接受急诊手术患者（Em组）与接受择期手术即非急诊手术患者（Ne组）的人口统计学数据、胎儿影像学表现以及术中及术后病程进行比较。
Em组和Ne组分别包括7例和11例患者。两组在孕周、产前诊断时间、出生体重和手术时体重方面无显著差异。Em组每胸段对侧肺体积明显小于Ne组（p = 0.0188）。Em组纵隔受压比Ne组更常见（7/7比4/11）（p = 0.0128）。
本文报告了应用肺体积比和纵隔移位通过胎儿MRI评估的CLC患者的新生儿急诊肺叶切除术情况。对于CLC患者，胎儿期纵隔移位和对侧肺体积显著减小是出生后急诊肺切除术的良好产前预测指标。
