Pediatric lung resection.: A case series and evaluation of postoperative lung function

The most common causes of pulmonary lobectomy in children are congenital lung malformations (CLM) and bronchiectasias. Our aim was to present the causes and clinical course and lung function of lobectomized patients. Between 1990 and July 1999 27 lobectomies were performed on patients whose ages ranged from newborn to 14 years. Lobectomies were performed to correct CLM in 124 cases and for acquired pulmonary disease (APD) in 13. Among CLM cases, half (n=7) had cystic adenomatoid malformation. Among the APD patients, 10 had bronchiectasias, with etiological confirmation in 6 cases (3 secondary to serious adenovirus infection). Mean hospital stay was 4.6 days among those who experienced no postoperative complications. Symptoms resolved after surgery for most symptomatic patients. Lung function tests could be carried out with 8 patients over 6 years old whose operations had taken place 7 to 78 months earlier (x=35 months) and whose age at the time of surgery was a mean 7 years 6 months (range 60 to 144 months). Spirometry showed normal forced vital capacity for 7 of 8 patients (87 to 14.3% of theoretical value). Arterial oxygen saturation measured during and after a 6-minute walking test was normal for 7 of 8 patients. Chest films showed reduced lung volume on the affected side in 5 of 8 patients. In summary, lobectomy is a procedure with few complications. It requires a short hospital stay and has good postoperative prognosis. Function and x-ray studies show adequate lung growth and development, with normal lung function in those who could be so examined because they were old enough to cooperate.