Congenital Lobar Emphysema: Perioperative Evaluation and Management

Area of Science:

• Pediatric Surgery
• Thoracic Surgery
• Neonatal Medicine

Background:

• Congenital lobar emphysema (CLE) is a rare lung malformation causing respiratory distress in neonates and infants.
• Characterized by overdistension and air trapping, CLE necessitates prompt diagnosis and management.
• It is a significant cause of respiratory distress in the neonatal and infantile population.

Purpose of the Study:

• To evaluate the perioperative and surgical management experience in children diagnosed with congenital lobar emphysema (CLE).
• To assess the outcomes and complications associated with surgical intervention for CLE.
• To highlight the importance of early diagnosis and management of CLE.

Main Methods:

• A retrospective observational study was conducted on 30 neonates and infants with CLE.
• Data collected included demographic, clinical, radiological, operative, and postoperative details.
• All patients underwent lobectomy as the surgical treatment for CLE.

Main Results:

• The study included 30 neonates and infants (21 males) with a mean age of 111.43 days.
• Common presentations included respiratory distress (100%), cyanosis (19), and recurrent pneumonia/fever (15).
• Lobectomy was performed on all patients, with a mean age at surgery of 147.58 days; 5 patients had complications, and 2 required mechanical ventilation. All patients showed good recovery post-surgery.

Conclusions:

• Congenital lobar emphysema (CLE) requires high clinical suspicion for persistent infantile respiratory distress.
• Chest CT is the preferred diagnostic modality for CLE.
• Early surgical management of CLE leads to improved outcomes and prevents severe complications, with surgical treatment being the choice at our center, demonstrating no mortality.