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Vol. 37. Issue 11.
Pages 482-488 (November 2001)
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Vol. 37. Issue 11.
Pages 482-488 (November 2001)
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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
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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
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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
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Copyright © 2001. Sociedad Española de Neumología y Cirugía Torácica
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