Surgery versus conservative management in congenital lobar emphysema: follow up and indicators for surgery
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In brief
In brief
Retrospective study of 20 pediatric patients with congenital lobar emphysema demonstrates that respiratory distress, mediastinal shift, and earlier age at diagnosis predict need for surgical intervention, while conservative management remains viable for less symptomatic cases with symptom reduction over time.
Written by the GCMD Library team from the article.
Abstract
Introduction
Congenital lobar emphysema (CLE), a rare developmental lung malformation, involves the hyperaeration of one or more lung lobes caused by partial obstruction and occurs at a rate of 1/20,000–30,000 live births. Here, we aimed to retrospectively examine the clinical, radiological, and bronchoscopy findings of patients with CLE who were diagnosed and treated by surgical or non-surgical (conservative) approaches at our center and compared our results with those in the literature.
Methods
We examined the clinical, radiological, and bronchoscopy findings of 20 patients with CLE aged 0–18 years at our center between 2013 and 2020. In addition, we examined the symptoms and findings recorded during the patients’ follow-up in this retrospective descriptive study.
Results
The median age of 20 patients with CLE at diagnosis was 3.2 years (range 1 day–17 years). Respiratory distress and mediastinal shift were more prominent in patients who underwent surgery, and they were diagnosed at an earlier age compared with patients who were followed up conservatively (p = 0.001, 0.049, 0.001, respectively). Neither the pulmonary lobe involvement nor the bronchoscopy findings were found to be indicative of surgery.
Discussion
We observed that respiratory distress and mediastinal shift were more prominent in patients with a diagnosis of CLE who underwent surgery compared with patients who were conservatively followed up. Moreover, we observed that those who underwent surgery were diagnosed with CLE at an earlier age. In line with the literature, the pulmonary symptoms and CLE-related imaging findings in our study were reduced during conservative follow-up.