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Surgery of acquired lobar emphysema in the neonate
Insights
Surgical lobectomies effectively treated localized pulmonary interstitial emphysema (PIE) in neonates. However, diffuse PIE in infants presents significant surgical challenges with lower survival rates.
Area of Science:
- Neonatal surgery
- Thoracic surgery
- Pediatric pulmonology
Background:
- Pulmonary interstitial emphysema (PIE) is increasingly reported in neonates.
- Surgical interventions are being explored for PIE management.
Purpose of the Study:
- To evaluate the efficacy of surgical interventions for localized and diffuse PIE in neonates.
- To compare outcomes between lobectomies for PIE and acquired lobar emphysema (ALE).
Main Methods:
- Pulmonary lobectomies were performed on 14 neonates with localized PIE.
- Multiple visceral pleurotomies were performed on six neonates with diffuse PIE.
Main Results:
- Lobectomies for localized PIE showed a success rate of 78.6% (11 out of 14 patients).
- Multiple visceral pleurotomies for diffuse PIE had a low survival rate of 16.7% (1 out of 6 patients).
- Acquired lobar emphysema (ALE) patients were successfully treated with lobectomies.
Conclusions:
- Pulmonary lobectomy is a successful treatment for localized PIE in neonates.
- Diffuse PIE in neonates is associated with poor surgical outcomes.
- Lobectomy is an effective treatment for acquired lobar emphysema.
Abstract:
Surgical treatment for pulmonary interstitial emphysema (PIE) has been reported with increasing frequency. We have done pulmonary lobectomies in 14 neonates with the localized form of PIE. This type of treatment was successful in 11 patients. Two patients expired in the hospital and one showed no improvement. Another six very compromised patients with diffuse PIE were treated during the same period with multiple visceral pleurotomies. Only one survived. Infants with diffuse PIE are usually poor surgical candidates, while those with acquired lobar emphysema (ALE) have been treated successfully with lobectomies.