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先天性肺畸形的外科治疗。

Surgical Management of Congenital Lung Malformations.

机构信息

Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX.

Texas Children's Fetal Center, Baylor College of Medicine, Houston, TX.

出版信息

Neoreviews. 2023 Feb 1;24(2):e84-e96. doi: 10.1542/neo.24-2-e84.

Abstract

Congenital lung malformations (CLMs) are commonly diagnosed prenatal lesions with varied natural history. Prenatal diagnosis and monitoring help to guide fetal interventions, delivery planning, and need for urgent perinatal surgical interventions. All prenatally diagnosed CLMs should be evaluated postnatally, typically with cross-sectional imaging, because many lesions persist despite the appearance of complete 'regression' in utero. Management of CLMs in asymptomatic infants weighs the surgical and anesthetic risk of prophylactic resection against the risk of expectant management, including the possibility of infection, malignant degeneration, and more complicated surgical resection later with loss of compensatory lung growth.

摘要

先天性肺畸形(CLM)是常见的产前病变,具有不同的自然病史。产前诊断和监测有助于指导胎儿干预、分娩计划和是否需要紧急围产期手术干预。所有产前诊断的 CLM 都应在产后进行评估,通常采用横断面成像,因为许多病变尽管在宫内表现出完全“消退”,但仍持续存在。无症状婴儿的 CLM 管理需要权衡预防性切除手术的风险和手术风险,包括感染、恶性转化以及以后更复杂的手术切除和代偿性肺生长损失的风险。

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