Journal Information
Vol. 37. Issue 11.
Pages 482-488 (November 2001)
Share
Share
Download PDF
More article options
Vol. 37. Issue 11.
Pages 482-488 (November 2001)
Full text access
Resección pulmonar en pediatría. Serie clínica y evaluación de la función pulmonar postoperatoria
Pediatric lung resection. A case series and evalua-tion of postoperative lung function
Visits
14027
S. Caussadea,
Corresponding author
mcaussa@med.puc.cl

Correspondencia: Dra. S. Caussade. Centro Especialidades Pediátricas. Universidad Católica de Chile.Marcoleta, 434. Santiago de Chile
, S. Zúñigab, C. Garcíac, S. Gonzálezd, E. Camposa, G. Sotoe, F. Zúñigaf, I. Sáncheza
a Sección de Aparato Respiratorio. Departamento de Pediatría. Hospital Clínico de la Universidad Católica de Chile
b Sección de Cirugía Pediátrica. División de Cirugía. Hospital Clínico de la Universidad Católica de Chile
c Departamentos de Radiología. Hospital Clínico de la Universidad Católica de Chile
d Departamentos de Anatomía Patológica. Hospital Clínico de la Universidad Católica de Chile
e Becario de Cirugía general. Hospital Clínico de la Universidad Católica de Chile
f Interno. Facultad de Medicina Sur. Hospital Clínico de la Universidad Católica de Chile
This item has received
Article information

Las causas más frecuentes de lobectomía pulmonar en ni-ños son las malformaciones pulmonares congénitas (MPC) y las bronquiectasias. Nuestro objetivo es presentar la casuís-tica y la evolución clínica y funcional respiratoria de pacien-tes lobectomizados. Entre 1990 y julio de 1999 se realizaron 27 lobectomías, entre recién nacidos y pacientes de 14 años. En 14 casos fue por MPC y en 13 por enfermedad pulmonar adquirida (EPA). Dentro de las MPC la mitad (n=7) co-rrespondieron a una malformación adenomatoidea quística. Del grupo de EPA 10 fueron bronquiectasias, con confirma-ción etiológica en 6 casos (3 secundarias a infección grave por adenovirus). De los pacientes que no presentaron com-plicación postoperatoria, el promedio de estancia hospitala-ria fue de 4, 6 días. Las complicaciones fueron la aparición de filtración aérea en 3 casos, requiriendo sólo un trata-miento quirúrgico. En la mayoría de los pacientes sintomáti-cos hubo resolución de los síntomas posterior a la cirugía. Se logró realizar un estudio funcional respiratorio a 8 pacientes mayores de 6 años, cuya intervención quirúrgica se había realizado entre 7 y 78 meses previos (media de 35 meses) y cuya edad en el momento de la cirugía fue, como promedio de 7 años y 6 meses (rango: 60–144 meses). La espirometría demostró una capacidad vital forzada normal en 7 de 8 pa-cientes (87-143% del valor teórico). La medición de la satu-ración arterial de oxígeno durante y posterior a una cami-nata de 6 min fue normal en 7 de 8 pacientes. La radiografía de tórax demostró una disminución del volumen pulmonar en el lado intervenido en 5 de 8 pacientes

En resumen, la lobectomía es un procedimiento con esca-sas complicaciones, requiere un período corto de hospitali-zación y presenta un buen pronóstico postoperatorio. Los estudios funcional y radiológico demuestran un adecuado crecimiento y desarrollo pulmonar, con una evaluación de la función pulmonar normal en aquellos pacientes que se pu-dieron estudiar por tener una edad suficiente para poder co-laborar en el examen

Palabras clave:
Resección pulmonar

The most common causes of pulmonary lobectomy in chil-dren are congenital lung malformations (CLM) and bron-chiectasias. Our aim was to present the causes and clinical course and lung function of lobectomized patients. Between 1990 and July 1999 27 lobectomies were performed on pa-tients whose ages ranged from newborn to 14 years. Lobec-tomies were performed to correct CLM in 124 cases and for acquired pulmonary disease (APD) in 13. Among CLM ca-ses, half (n=7) had cystic adenomatoid malformation. Among the APD patients, 10 had bronchiectasias, with etio-logical confirmation in 6 cases (3 secondary to serious ade-novirus infection). Mean hospital stay was 4.6 days among those who experienced no postoperative complications. Symptoms resolved after surgery for most symptomatic pa-tients. Lung function tests could be carried out with 8 pa-tients over 6 years old whose operations had taken place 7 to 78 months earlier (x=35 months) and whose age at the time of surgery was a mean 7 years 6 months (range 60 to 144 months). Spirometry showed normal forced vital capacity for 7 of 8 patients (87 to 143% of theoretical value). Arterial oxygen saturation measured during and after a 6-minute walking test was normal for 7 of 8 patients. Chest films sho-wed reduced lung volume on the affected side in 5 of 8 pa-tients

In summary, lobectomy is a procedure with few complica-tions. It requires a short hospital stay and has good postope-rative prognosis. Function and x-ray studies show adequate lung growth and development, with normal lung function in those who could be so examined because they were old enough to cooperate

Keywords:
Pulmonary resection
Full text is only aviable in PDF
Bibliografía
[1.]
J. Dubernet, H. Oddo, R. Burdach, H. Salvestrini, A. Lucchini, G. Natura, et al.
Resección pulmonar en niños.
Arch Soc Cir Chile, 21 (1969), pp. 187-190
[2.]
P. Pianosi.
Diagnostic and therapeutic procedures. Lung resection.
Kendig's disorders of the respiratory tract in children, 6.a ed, pp. 120-121
[3.]
M. Ribet, M. Copin, B. Gosselin.
Bronchogenic cysts of the lung.
Ann Thorac Surg, 61 (1996), pp. 1636-1640
[4.]
I. Neilson, P. Russo, J. Laberge, D. Filiatrault, L. Nguyen, et al.
Congenital adenomatoid malformation of the lung: current management and prognosis.
J Pediatr Surg, 26 (1991), pp. 975-981
[5.]
M. Schwartz, P. Ramachandran.
Congenital malformations of the lung and mediastinum – a quarter century of experience from a single institution.
J Pediatr Surg, 32 (1997), pp. 44-47
[6.]
F. Becmeur, P. Horta-Geraud, L. Donato, P. Sauvage.
Pulmonary sequestrations: prenatal ultrasound diagnosis, treatment and outcome.
J Pediatr Sur, 33 (1998), pp. 492-496
[7.]
C. Dell'Agnola, B. Tadini, F. Mosca.
Prenatal ultrasonography and early surgery for congenital cystic disease of th elung.
J Pediatr Surg, 27 (1992), pp. 1414-1417
[8.]
T. Agasthian, C. Deschamps, V. Tastrek, M. Allen, P. Pairolero.
Surgical management of bronchiectasis.
Ann Thorac Surg, 62 (1996), pp. 976-980
[9.]
S. Nikolaizik, J. Warner.
Aetiology of chronic suppurative lung disease.
Arch Dis Child, 70 (1994), pp. 141-142
[10.]
M. Brown, R. Lemen.
Bronchiectasias.
Kendig's disorders of the respiratory tract in children, 6.a ed, pp. 538-552
[11.]
B. Wilcox, G. Murray, M. Friedman, R. Pimmel.
The effects of early pneumonectomy of the remaing pulmonary parenchyma Surg, 86 (1979), pp. 294-300
[12.]
H. Werner, G. Pirie, H. Nadel, A. Fleisher, J. Le Blanc.
Lung volumes, mechanics and perfusion after pulmonary resection in infancy.
J Thorac Cardiovasc Surg, 105 (1993), pp. 737-742
[13.]
C. Laros, J. Westermann.
Dilatation, compensatory growth, or both after pneumonectomy during chidhood and adolescence.
J Thorac Cardiovasc Surg, 93 (1987), pp. 570-576
[14.]
J. McBride, M. Wohl, D. Strieder, A. Jackson, J. Morton, Zwedling, et al.
Lung growth and airway function after lobectomy in infancy for congenital lobar enfisema.
J Clin Invest, 66 (1980), pp. 962-970
[15.]
R. Knudson, M. Lebowtz, C. Holberg, B. Burrows.
Changes in the normal maximal expiratory flow-volume curve with growth and aging.
Am Rev Respir Dis, 127 (1983), pp. 725-734
[16.]
P. Bailey, T. Tracy, R. Connors, D. de Mello, J. Lewis, T. Weber.
Congenital bronchopulmonary malformations.
J Thorac Cardiovasc Surg, 99 (1990), pp. 597-603
[17.]
A. Coran, R. Drongowsky.
Congenital cystic disease of the tracheobronquial tree in infants and children.
Arch Surg, 129 (1994), pp. 521-527
[18.]
D. Browdie, D. Todd, R. Agnew, W. Rosen, H. Beardmore.
The use of “nonanatomic” pulmonary resection in infants with extensive congenital adenomatoid malformation of the lung.
J Thorac Cardiovasc Surg, 105 (1993), pp. 732-736
[19.]
S. Mentzer, R. Filler, J. Phillips.
Limited pulmonary resections for congenital cystic adenomatoid malformation of the lung.
J Pediatr Surg, 27 (1992), pp. 1410-1413
[20.]
L. Nicolette, A. Kosloske, S. Bartow.
Intralobar pulmonary sequestration: a clinical and pathological spectrum.
J Pediatr Surg, 28 (1993), pp. 802-805
[21.]
A. Cohen, C. Roifman, M. Brendan, M. Mullen, B. Reid, G. Weisbrod, et al.
Localised pulmonary resection for bronchiectasis in hypogammaglobulinaemic patients.
Thorax, 49 (1994), pp. 509-510
[22.]
R. Kravitz.
Congenital malformations of the lung.
Pediatr Clin North Am, 41 (1994), pp. 453-472
[23.]
M. Hernanz-Schulman.
Cysts and cystlike lesions of the lung.
Radiol Clin North Am, 31 (1993), pp. 631-649
[24.]
K. Stigers, J. Woodring, J. Kanga.
The clinical and imaging spectrum of finding in patients with congenital lobar emphysema.
Pediatr Pulmonol, 14 (1992), pp. 160-170
[25.]
L. Smart, M. Hendry.
Imaging of neonatal pulmonary sequestration including Doppler ultrasound.
Br J Radiol, 64 (1991), pp. 324-329
[26.]
S. Zúñiga, G. Soto, C. Sepúlveda, C. García, O. Contreras, I. Sánchez.
Una década de experiencia en malformación adenomatoidea quística del pulmón.
Rev Chil Enf Respir, 14 (1998), pp. 128-136
[27.]
G. Torres, X. Raimann, G. Aldunate, A. Díaz.
Malformación adenomatoidea quística pulmonar.
Rev Child Enf Respir, 88 (1992), pp. 26
[28.]
H. Louie, S. Martin, D. Mulder.
Pulmonary sequestration: 17-year experience al UCLA.
Am Surg, 59 (1993), pp. 801-805
[29.]
J. Franco, R. Aliaga, M. Domingo, P. Plaza.
Diagnosis of pulmonary sequestration by spiral CT angiography.
Thorax, 53 (1998), pp. 1089-1092
[30.]
M. Dommergues, C. Louis-Sylvestre, L. Mandelbrot, M. Aubry, Y. Révillon, P. Jarreau, et al.
Congenital adenomatoid malformation of the lung: When is active fetal therapy indicated?.
Am J Obstet Gynecol, 177 (1997), pp. 953-958
[31.]
S. Adzick, M. Harrison.
Management of the fetus with cystic adenomatoid malformation.
World J Surg, 17 (1993), pp. 343-349
[32.]
S. Adzick, M. Harrison, A. Flake.
Fetal surgery for cystic adenomatoid malformation of the lung.
J Pediatr Surg, 28 (1993), pp. 806-812
[33.]
H. Heij, S. Ekkelkamp, A. Vos.
Diagnosis of congenital cystic adenomatoid malformations of the lung in newbron infants and children.
Thorax, 45 (1990), pp. 122-125
[34.]
C. Granata, C. Gambini, T. Balducci.
Bronchioalveolar carcinoma arising in congenital cystic adenomatoid malformation in a child; a case report and review on malignancies originating in congenital cystic adenomatoid malformation.
Pediatr Pulmonol, 25 (1998), pp. 62-66
[35.]
S. D'Agostino, E. Bonoldi, S. Dante, et al.
Embryonal rhabdomyosarcoma of the lung arising in cystic adenomatoid malformation: case report and review of the literature.
J Pediatr Surg, 32 (1997), pp. 1381-1383
[36.]
R. Kaslovsky, S. Purdy, B. Dangman, B. McKenna, T. Brien, R. Ilves.
Bronchioalveolar carcinoma in a child with congenital cystic adenomatoid malformation.
Chest, 112 (1997), pp. 48-51
[37.]
D. Man, M. Hamdy, G. Hendry.
Congenital lobar emphysema: problems in diagnosis and management.
Arch Dis Child, 58 (1983), pp. 709-712
[38.]
N. Lewinston.
Bronchiectasias.
Hilman pediatric respiratory diaseses, pp. 222-229
[39.]
J. Wilson, A. Decker.
The surgical management of childhood bronchiectasis.
Ann Surg, 195 (1982), pp. 354-363
[40.]
R. Bragonier, D. Grier, F. Carswell, S. Cunningham.
Lobectomy in cystic fibrosis.
Respir Med, 92 (1998), pp. 695-697
[41.]
M. Smith, W. Hardin, D. Dressel, et al.
Predicting outcome following pulmonary resection in cystic fibrosis patients.
J Pediatr Surg, 26 (1991), pp. 655-659
[42.]
W. Walker, F. Carnochan, G. Pugh.
Thoracoscopic pulmonary lobectomy. Early operative experience and prelimnary clinical results.
J Thorac Cardiovasc Surg, 106 (1993), pp. 111-117
[43.]
C. Suárez, C. Czischke, J. Lemus, P. Rodríguez, D. Paulov, J. Rocabado, et al.
Resecciones pulmonares por videotoracoscopia en cirugía experimental animal.
Rev Chil Cir, 48 (1996), pp. 38-41
[44.]
K. Koizumi, T. Akaishi, A. Wakabayashi.
Anatomic segmental resection of the lung by thoracoscopy: an experimental study.
Surg Today, 27 (1997), pp. 1051-1055
[45.]
P. Cagle, W. Thurlbeck.
Postpneumonetomy compensatory lung growth.
Am Rev Respir Dis, 138 (1988), pp. 1314-1326
[46.]
J. Stocker, J. Madewell, R. Drake.
Congenital cystic adenomatoid malformation of the lung. Classification and morphologic spectrum.
Hum Pathol, 8 (1977), pp. 155-171
Copyright © 2001. Sociedad Española de Neumología y Cirugía Torácica
Archivos de Bronconeumología
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?