Surgical salvage of acquired lung lesions in extremely premature infants

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• 作者：Greg D. Sacks (1)
  Katherine Chung (2)
  Kevin Jamil (1)
  Meena Garg (2)
  James C. Y. Dunn (1)
  Daniel A. DeUgarte (1)
  
• 关键词：Lung ; Pulmonary ; Lymphatic ; Bronchopleural fistula ; Thoracotomy ; Pulmonary interstitial emphysema ; Cystic bronchopulmonary dysplasia ; Persistent air leak
• 刊名：Pediatric Surgery International
• 出版年：2014
• 出版时间：May 2014
• 年：2014
• 卷：30
• 期：5
• 页码：573-576
• 全文大小：423 KB
• 参考文献：1. Hussain N et al (2010) Pneumatoceles in preterm infants-incidence and outcome in the post-surfactant era. J Perinatol 30(5):330-36 CrossRef
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• 作者单位：Greg D. Sacks (1)
  Katherine Chung (2)
  Kevin Jamil (1)
  Meena Garg (2)
  James C. Y. Dunn (1)
  Daniel A. DeUgarte (1)
  
  1. Division of Pediatric Surgery, Department of Surgery, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, P. O. Box 709818, Los Angeles, CA, 90095-7098, USA
  2. Division of Pediatric Neonatology, David Geffen School of Medicine at UCLA, Los Angeles, USA
  
• ISSN：1437-9813

文摘

Acquired neonatal lung lesions including pneumatoceles, cystic bronchopulmonary dysplasia, and pulmonary interstitial emphysema can cause extrinsic mediastinal compression, which may impair pulmonary and cardiac function. Acquired lung lesions are typically managed medically. Here we report a case series of three extremely premature?infants with acquired lung lesions. All three patients underwent aggressive medical management and ultimately required tube thoracostomies. These interventions were unsuccessful and emergency thoracotomies were performed in each case. Two infants with acquired pneumatoceles underwent unroofing of the cystic structure and primary repair of a bronchial defect. The third infant with pulmonary interstitial emphysema, arising from cystic bronchopulmonary dysplasia, required a middle lobectomy for severe and diffuse cystic disease. When medical management fails, tube thoracostomy can be attempted, leaving surgical intervention for refractory cases. Surgical options include oversewing a bronchial defect in the setting of a bronchopleural fistula or lung resection in cases of an isolated expanding lobe.