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Original Articles: General Thoracic

Pneumonectomy in Children for Destroyed Lung: Evaluation of 18 Cases

^a Sureyyapasa Chest Disease and Chest Surgery Training and Research Hospital, Istanbul, Turkey
^b Medical Faculty of Maltepe University Thoracic Surgery Clinic, Istanbul, Turkey
^c Kartal Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey

Accepted for publication October 6, 2009.

^_* Address correspondence to Dr Kosar, Sureyyapasa Chest Disease and Chest Surgery Training and Research Hospital, Department of Thoracic Surgery, Ataturk cad. Murat Apt. 46/16, Erenkoy, Istanbul, 34734, Turkey (Email: altugkosar{at}yahoo.com).

Background: Destroyed lung is an uncommon condition; it describes a nonfunctional lung and is most often caused by inflammatory diseases. Surgical resection is used to resolve or prevent complications and improve quality of life. We reviewed our experience in surgery for destroyed lung in children.

Methods: The records of 18 children aged 16 years and younger who had undergone pneumonectomy for destroyed lung between 1991 and 2007 were analyzed retrospectively.

Results: Eighteen children, 10 males (55.5%) and 8 females, aged 5 to 16 years, with a mean age of 12.3 underwent pneumonectomy. Cough was the major presenting symptom (n = 18, 100%). The median preoperative period for symptoms was 6 years. Radiologic diagnostic methods included chest radiograph, computed tomography, bronchoscopy, and bronchography. Bronchiectasis (n = 13), tuberculosis (n = 4), and aspergillosis (n = 1) were the main pathologies. Five patients had tuberculosis history, and tuberculosis culture was positive in 2 patients. Pneumonectomy was applied to the left side in 14 and right side in 4 patients. There was no mortality. Complication occurred in 3 patients (atelectasis [n = 1], fistula and empyema [n = 1], and wound infection [n = 1]). Atelectasis was treated with bronchoscopy and stoma was needed for another patient for empyema. The mean follow-up was 64.9 months (range, 19 to 164 months). In their follow-up period, scoliosis was found in 1 patient.

Conclusions: The morbidity and mortality rates of pneumonectomy are acceptable for selected and well prepared children. Antibiotics and antituberculosis treatment in certain cases and good timing in pneumonectomy are essential. Children grew and developed normally after pneumonectomy.

This article has been cited by other articles:

				L. Bai, Z. Hong, C. Gong, D. Yan, and Z. Liang Surgical treatment efficacy in 172 cases of tuberculosis-destroyed lungs Eur J Cardiothorac Surg, February 1, 2012; 41(2): 335 - 340. [Abstract] [Full Text] [PDF]