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Physiologic consequences of pneumonectomy. Consequences on the pulmonary function
F Tronc1, J Grégoire, P Leblanc
1Division of Thoracic Surgery, Centre de pneumologie de L'Hôpital Laval, Sainte-Foy, Quebec, Canada.
Insights
Children may experience lung growth after pneumonectomy, unlike adults whose lung volume response is limited. This review explores the physiological mechanisms behind compensatory lung growth following pneumonectomy in both humans and animals.
Area of Science:
- Pediatric Pulmonology
- Thoracic Surgery
- Respiratory Physiology
Background:
- Pneumonectomy, the surgical removal of a lung, raises questions about compensatory lung growth.
- Adults show limited lung volume response post-pneumonectomy, primarily due to alveolar distention, not multiplication.
- Mechanical stretch is considered a key initiator of compensatory growth.
Purpose of the Study:
- To review the physiological adjustments following pneumonectomy.
- To investigate the potential for lung growth in pediatric patients after pneumonectomy.
- To discuss the mechanisms and mediators of adaptive lung responses.
Main Methods:
- Review of existing human observational data.
- Analysis of experimental findings in animal models.
- Discussion of physiological mechanisms and mediators.
Main Results:
- Adult compensatory lung growth is incomplete, characterized by alveolar distention.
- Stretch is a primary stimulus for compensatory growth.
- The review synthesizes data on human and animal responses to pneumonectomy.
Conclusions:
- Pneumonectomy elicits complex physiological adaptations.
- Further research is needed to fully understand pediatric lung growth post-pneumonectomy.
- Mechanisms of compensatory lung growth involve various mediators and cellular responses.
Abstract:
When pneumonectomy is done in children, there is some speculation that lung growth occurs. In the adult population, volume response is incomplete and attributable to alveolar distention rather than multiplication. Stretch is widely regarded as the initial stimulus for compensatory growth. The authors review data pertaining to the physiology of the various adjustments that occur after pneumonectomy gathered both from observations on human response and from experimental findings in animals. Mechanisms and mediators of this adaptive response are discussed.