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Congenital lobar emphysema: 30-year case series in two university hospitals / Enfisema lobar congenito: serie de casos de 30 anos em dois hospitais universitarios
Cataneo, Daniele Cristina; Rodrigues, Olavo Ribeiro; Hasimoto, Erica Nishida; Schmidt Jr, Aurelino Fernandes; Cataneo, Antonio Jose Maria.
  • Cataneo, Daniele Cristina; s.af
  • Rodrigues, Olavo Ribeiro; s.af
  • Hasimoto, Erica Nishida; s.af
  • Schmidt Jr, Aurelino Fernandes; s.af
  • Cataneo, Antonio Jose Maria; s.af
J. bras. pneumol ; 39(4): 418-426, June-August/2013. tab, graf
Article in English | LILACS | ID: lil-686601
ABSTRACT

OBJECTIVE:

To review the cases of patients with congenital lobar emphysema (CLE) submitted to surgical treatment at two university hospitals over a 30-year period.

METHODS:

We reviewed the medical records of children with CLE undergoing surgical treatment between 1979 and 2009 at the Botucatu School of Medicine Hospital das Clínicas or the Mogi das Cruzes University Hospital. We analyzed data regarding symptoms, physical examination, radiographic findings, diagnosis, surgical treatment, and postoperative follow-up.

RESULTS:

During the period studied, 20 children with CLE underwent surgery. The mean age at the time of surgery was 6.9 months (range, 9 days to 4 years). All of the cases presented with symptoms at birth or during the first months of life. In all cases, chest X-rays were useful in defining the diagnosis. In cases of moderate respiratory distress, chest CT facilitated the diagnosis. One patient with severe respiratory distress was misdiagnosed with hypertensive pneumothorax and underwent chest tube drainage. Only patients with moderate respiratory distress were submitted to bronchoscopy, which revealed no tracheobronchial abnormalities. The surgical approach was lateral muscle-sparing thoracotomy. The left upper and middle lobes were the most often affected, followed by the right upper lobe. Lobectomy was performed in 18 cases, whereas bilobectomy was performed in 2 (together with bronchogenic cyst resection in 1 of those). No postoperative complications were observed. Postoperative ...
RESUMO

OBJETIVO:

Revisar os casos de enfisema lobar congênito (ELC) operados nos últimos 30 anos em dois hospitais universitários.

MÉTODOS:

Foram revistos os prontuários médicos das crianças com ELC operadas no Hospital das Clínicas da Faculdade de Medicina de Botucatu e no Hospital da Universidade de Mogi das Cruzes entre 1979 e 2009. Dados sobre sintomas, exame físico, achados radiológicos, diagnóstico, tratamento cirúrgico e seguimento pós-operatório mediato e tardio foram analisados.

RESULTADOS:

Durante o período estudado, 20 crianças com ELC foram submetidas a tratamento cirúrgico. A média de idade dos pacientes no momento da cirurgia foi 6,9 meses (variação, 9 dias a 4 anos). Todos os casos apresentaram sintomas ao nascimento ou nos primeiros meses de vida. Em todos os casos, a radiografia simples de tórax foi importante na definição do diagnóstico. Em casos de dificuldade respiratória moderada, a TC de tórax auxiliou no diagnóstico. Um paciente com desconforto respiratório grave foi diagnosticado erroneamente com pneumotórax hipertensivo e submetido a drenagem torácica. A broncoscopia só foi realizada nos pacientes com dificuldade respiratória moderada e não foram encontrados sinais de anomalias traqueobrônquicas. A abordagem cirúrgica foi realizada através de toracotomia lateral poupadora de músculo. O lobo superior esquerdo e o lobo médio ...
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Pulmonary Emphysema Type of study: Observational study Limits: Child, preschool / Female / Humans / Infant / Male / Infant, Newborn Language: English Journal: J. bras. pneumol Journal subject: Pulmonary Disease (Specialty) Year: 2013 Type: Article

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Full text: Available Index: LILACS (Americas) Main subject: Pulmonary Emphysema Type of study: Observational study Limits: Child, preschool / Female / Humans / Infant / Male / Infant, Newborn Language: English Journal: J. bras. pneumol Journal subject: Pulmonary Disease (Specialty) Year: 2013 Type: Article