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[Follow-up study of pulmonary function in individuals subjected to lobectomy in infancy and childhood]
Insights
Children undergoing lung lobectomy show significant functional recovery, with residual lung capacity improving over time. This suggests positive long-term outcomes for pediatric patients after pulmonary exeresis.
Area of Science:
- Pediatric surgery
- Pulmonology
- Developmental biology
Context:
- Pulmonary development continues postnatally in humans, extending into early adulthood.
- Surgical removal of lung portions (lobectomy) in children may impact respiratory function.
- Understanding long-term lung recovery is crucial for pediatric surgical outcomes.
Purpose:
- To investigate the functional recovery of the residual lung in children after lobectomy.
- To assess the long-term respiratory outcomes in pediatric patients who underwent pulmonary exeresis.
Summary:
- Eight children (4 days to 8 years) underwent lobectomy for various conditions.
- Follow-up ranged from 3 to 25 years, with most patients enjoying normal active lives.
- Evaluations included blood gas analysis, ECG, X-ray, spirometry, and scintigraphy, indicating satisfactory functional recovery despite variable spirometry and scintigraphy results.
Impact:
- Demonstrates the potential for significant functional recovery in the pediatric residual lung.
- Supports the hypothesis that respiratory deficits post-lobectomy can regress over time in children.
- Provides evidence for positive long-term quality of life following pediatric lung surgery.
Abstract:
Experimental research in animals have demonstrated that pulmonary development continues after birth. This happens in man as well: alveolar proliferation and enlargement go on until the eighth year of age, furthermore complete pulmonary development is achieved until the 20-22 years of age. It is therefore possible to hypothesise that respiratory deficit following pulmonary exeresis in children would regress with time. In the Pediatric Surgery of IRCCS Policlinico S. Matteo of Pavia eight children, 4 days to 8 years of age, underwent lobectomy for pulmonary hypertensive emphysema (3), lung abscess (2), bronchogenic cysts (2) and hystiocytoma (1). One of them was lost to follow-up; the remainders were controlled from 3 to 25 years after surgery: all of them enjoy a normal active life. Respiratory function was evaluated through blood chemistry, blood gas analysis, basal and after strain ECG, chest X-ray, spirometry, basal and after strain pulmonary scintigraphy. Basal and after strain ECG, chest X-ray, and arterial blood gas were normal in every examined subjects; spirometry, although results are quite variable, did not show serious respiratory deficits; basal after strain pulmonary scintigraphies weren't homogeneous. These results, although they aren't univocally interpretable, positively confirmed that the residual lung after lobectomy has a satisfactory possibility of functional recovery.