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A contemporary evaluation of pulmonary function in children undergoing lung resection in infancy
Alana Beres1, Ann Aspirot, Catherine Paris
1The Montreal Children's Hospital of McGill University Health Centre, Division of Pediatric General Surgery, Montreal, Quebec, Canada, H3H 1P3.
Insights
Infants with congenital lung lesions who had surgery before one year old generally maintain normal pulmonary function. This supports early, elective resection for these conditions.
Area of Science:
- Pediatric Surgery
- Pulmonology
- Congenital Abnormalities
Background:
- Management of asymptomatic congenital lung lesions remains debated.
- Surgical resection in infancy and observation are common approaches.
- Pulmonary function in children undergoing early resection is not well-established.
Purpose of the Study:
- To evaluate pulmonary function in children who underwent lung resection at 12 months or younger.
- To test the hypothesis that early resection does not significantly impair pulmonary function.
Main Methods:
- Prospective recruitment of patients who had lung resection at <= 12 months of age and are now > 5 years old.
- Standardized pulmonary function testing (PFT) was performed.
- Normal PFT values defined as >80% of predicted.
Main Results:
- 19 children had PFT data analyzed (4 excluded).
- Forced vital capacity was normal in 93% of patients.
- Forced expiratory volume in 1 second was normal in 86% of patients.
- Diffusion capacity and respiratory muscle strength were normal in all tested.
Conclusions:
- The majority of children undergoing infant lung resection exhibit normal pulmonary function.
- Findings support the strategy of early, elective resection for congenital lung lesions.
- Early surgical intervention appears safe regarding long-term pulmonary health.
Background/Purpose:
The management of asymptomatic congenital lung lesions is controversial. Some centers recommend resection in infancy, and others prefer observation. Our objective was to evaluate the pulmonary function of children who underwent lung resection at 12 months or younger. We hypothesized that these children would not have a significant reduction in pulmonary function when compared with norms for age.
Methods:
All patients at 2 tertiary-care children's hospitals who underwent lung resection at 12 months or younger and are currently older than 5 years were identified and prospectively recruited. Pulmonary function testing was standardized in all patients.
Results:
Fourteen children were tested prospectively, whereas results were available for another 5 children. Four children were excluded for inability to perform pulmonary function testing (n = 2) or for preexisting pulmonary hypoplasia/syndrome (n = 2). Pulmonary function testing values were considered normal if they were more than 80% of predicted. Forced vital capacity was normal in 14 (93%) of 15 children, and forced expiratory volume in 1 second was normal in 13 (86%) of 15 children. Diffusion capacity and respiratory muscle strength were normal in all children tested.
Conclusions:
Most children undergoing lung resection in infancy will have normal pulmonary function tests, supporting our philosophy of early, elective resection of congenital lung lesions.
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