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Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
Published on: March 6, 2019
Congenital lung malformations
Cristiano Feijó Andrade1, Hylas Paiva da Costa Ferreira, Gilberto Bueno Fischer
1Santo Antônio Children's Hospital, Santa Casa Sisters of Mercy Hospital Complex, Porto Alegre, Brazil. cristianofa@cirurgiatoracica.net
Insights
Congenital lung malformations (CLMs) are rare conditions diagnosed prenatally. Early detection and surgical resection, often lobectomy, are recommended to prevent complications and ensure normal lung development.
Area of Science:
- Pediatric Surgery
- Thoracic Surgery
- Congenital Abnormalities
Background:
- Congenital lung malformations (CLMs) are rare, with variable presentation and severity.
- They can cause significant morbidity and mortality in infants and children.
- Prenatal ultrasound has increased early diagnosis rates.
Purpose of the Study:
- To describe principal congenital lung malformations.
- To review diagnostic approaches for CLMs.
- To discuss treatment controversies and recommendations.
Main Methods:
- Review of literature on congenital lung malformations.
- Analysis of clinical presentation, diagnosis, and management strategies.
- Discussion of surgical interventions, primarily lobectomy.
Main Results:
- CLMs manifest from respiratory distress to asymptomatic findings.
- Early diagnosis is possible with prenatal ultrasound.
- Lobectomy is the preferred surgical treatment with excellent outcomes.
Conclusions:
- Prompt diagnosis and treatment, including resection, are crucial for optimal lung development.
- Management depends on malformation type and symptoms.
- Surgical resection is often recommended due to complication risks.
Abstract:
Congenital lung malformations are rare and vary widely in their clinical presentation and severity, depending mostly on the degree of lung involvement and their location in the thoracic cavity. They can manifest at any age and can be the source of significant morbidity and mortality in infants and children. Individuals with congenital lung malformations can present with respiratory symptoms at birth or can remain asymptomatic for long periods. Recently, there has been an increase in the early diagnosis of these malformations, a change that is attributable to the routine use of prenatal ultrasound. The clinical manifestation of these malformations varies from respiratory distress in the immediate postnatal period to an incidental finding on chest X-rays. Early diagnosis and prompt treatment offer the possibility of absolutely normal lung development. The treatment of asymptomatic patients with lung malformations is controversial, because the prognosis of these diseases is unpredictable. The management of these lesions depends on the type of malformation and symptoms. Because of the risk of complications, most authors recommend resection of the lesion at the time of diagnosis. Lobectomy is the procedure of choice and yields excellent long-term results. This article describes the principal congenital lung malformations, their diagnosis, and the controversies regarding treatment.
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