Section of Pediatric Surgery, Department of Surgery, Michigan Medicine, C.S. Mott, Children's and Von Voigtlander Women's Hospital, Ann Arbor, MI, USA 48109; Pediatric Surgical Critical Care, Department of Surgery, Michigan Medicine, C.S. Mott, Children's and Von Voigtlander Women's Hospital, Ann Arbor, MI, USA 48109.
Section of Pediatric Surgery, Department of Surgery, Michigan Medicine, C.S. Mott, Children's and Von Voigtlander Women's Hospital, Ann Arbor, MI, USA 48109.
J Pediatr Surg. 2019 Sep;54(9):1766-1770. doi: 10.1016/j.jpedsurg.2019.01.056. Epub 2019 Feb 24.
The purpose of this study was to evaluate short-term respiratory outcomes in neonates with symptomatic congenital lung malformations (CLM).
Consecutive newborns who underwent surgical resection of a CLM were retrospectively reviewed. Demographic, prenatal, and outcomes data were analyzed as appropriate (p < 0.05).
Twenty-one neonates were managed at a median gestational age of 36.2 weeks [interquartile range (IQR), 33.8-39.0]. Endotracheal intubation was required in 14 (66.7%) for a median of 7.5 days [interquartile range (IQR), 3.0-25.8]. Three (14.3%) children underwent ex utero intrapartum treatment-to-resection, and another 14 (66.7%) had neonatal lung resections performed at a median age of 2.0 days (IQR, 0.08-19.5 days). Excluding one patient who received comfort care at birth, all neonates survived to hospital discharge with a median length of hospitalization of 36.5 days (IQR, 23.8-56.5). More than one-quarter were discharged on supplemental oxygen by nasal cannula. Based on a median follow up of 35.5 months (IQR, 19.0-80.8), CLM-related morbidity was still evident in 55.0%.
Our study suggests a high incidence of complications and chronic respiratory morbidity after neonatal lung resection for symptomatic CLMs. These data highlight the need to provide realistic expectations in perinatal counseling discussions with families and the importance of coordinating appropriate multidisciplinary follow up for these children.
Level IV.
本研究旨在评估有症状先天性肺畸形（CLM）新生儿的短期呼吸结局。
回顾性分析了接受 CLM 手术切除的连续新生儿。对人口统计学、产前和结局数据进行了适当分析（p<0.05）。
21 例新生儿的中位胎龄为 36.2 周[四分位距（IQR），33.8-39.0]。14 例（66.7%）需要气管插管，中位时间为 7.5 天[IQR，3.0-25.8]。3 例（14.3%）患儿接受了子宫外产时治疗-切除，14 例（66.7%）新生儿在中位年龄 2.0 天[IQR，0.08-19.5 天]行肺切除术。除 1 例患儿出生时接受舒适护理外，所有新生儿均存活至出院，中位住院时间为 36.5 天[IQR，23.8-56.5]。超过四分之一的患儿出院时需要经鼻导管吸氧。基于中位数为 35.5 个月（IQR，19.0-80.8）的随访，55.0%的患儿仍存在 CLM 相关并发症和慢性呼吸系统疾病。
我们的研究表明，新生儿肺切除术后有症状 CLM 会导致并发症和慢性呼吸系统疾病发病率较高。这些数据强调了在围产期咨询讨论中向家庭提供现实期望的必要性，以及为这些儿童协调适当的多学科随访的重要性。
IV 级。
