Related Experiment Videos
Congenital lobar emphysema: long-term evaluation of surgically and conservatively treated children
Insights
Surgically treated congenital lobar emphysema (CLE) did not show improved lung function compared to conservative treatment. Asymptomatic or mildly symptomatic patients with CLE do not benefit from surgery.
Area of Science:
- Pediatric Pulmonology
- Thoracic Surgery
Background:
- Congenital lobar emphysema (CLE) is a rare condition affecting newborns.
- Treatment options include surgery or conservative management.
Purpose of the Study:
- To compare clinical outcomes, radiographic findings, and pulmonary function in children with CLE treated surgically versus conservatively.
- To determine if surgical intervention offers benefits for asymptomatic or mildly symptomatic patients.
Main Methods:
- Retrospective comparison of 6 surgically treated (Group 1) and 5 conservatively treated (Group 2) children with CLE.
- Assessment of clinical status, chest radiography, and pulmonary function tests at follow-up.
Main Results:
- All patients were asymptomatic at the time of study.
- Surgically treated patients showed generalized overinflation, while conservatively treated patients had localized overinflation.
- Pulmonary function tests were not significantly different between groups, with both exhibiting reduced forced vital capacity and trapped gas.
Conclusions:
- Lung growth was comparable in both treatment groups.
- Surgical treatment for congenital lobar emphysema does not appear to benefit asymptomatic or mildly symptomatic patients.
Abstract:
The clinical conditions, roentgenographic findings, and pulmonary function tests of 6 children (mean age, 10.9 years) with surgically treated congenital lobar emphysema (group 1) were compared with those of 5 children (mean age, 10.3 years) with congenital lobar emphysema who had been treated conservatively, i.e., nonsurgically (group 2). At the time of this study, patients in both groups were asymptomatic. Patients in group 1 were surgically treated because of severe respiratory distress in the newborn period, with the exception of one patient, who was eupneic as a newborn and was not operated on until the age of 9 years. Patients in group 2 were eupneic or mildly distressed in the neonatal period and received only conservative treatment. Two patients in group 1 had occasional wheezing and labored breathing, but no patient in group 2 had recurrent respiratory distress. Roentgenographically, at the time of the study, patients in group 1 had generalized overinflation, whereas those in group 2 had only localized overinflation of the involved lobe and minimal compression of remaining lung tissue. Pulmonary function studies in both groups were not significantly different (P greater than 0.05). Both groups had reduced forced vital capacities, large trapped gas volumes, and reduced forced expiratory flows at low lung volumes. Reductions in forced vital capacity were proportional to the unventilated volumes of lung either excised because of congenital lobar emphysema (group 1) or chronically obstructed by congenital lobar emphysema (group 2). These studies suggest that lung growth was not different in these 2 groups and that asymptomatic or midly symptomatic patients do not benefit from surgical treatment.