[Pulmonary lobectomy in children: the sooner the better?]

Autor:	Triana Junco P; Servicio de Cirugía Pediátrica. Hospital Universitario La Paz. Madrid., de la Torre C; Servicio de Cirugía Pediátrica. Hospital Universitario La Paz. Madrid., Barrio MI; Servicio de Neumología Infantil. Hospital Universitario La Paz. Madrid., de la Serna O; Servicio de Neumología Infantil. Hospital Universitario La Paz. Madrid., Dore Reyes M; Servicio de Cirugía Pediátrica. Hospital Universitario La Paz. Madrid., Núñez V; Servicio de Cirugía Pediátrica. Hospital Universitario La Paz. Madrid., Jiménez J; Servicio de Cirugía Pediátrica. Hospital Universitario La Paz. Madrid., Martínez Martínez L; Servicio de Cirugía Pediátrica. Hospital Universitario La Paz. Madrid., Madero R; Bioestadística. Hospital Universitario La Paz. Madrid., Encinas JL; Servicio de Cirugía Pediátrica. Hospital Universitario La Paz. Madrid., Hernández Oliveros F; Servicio de Cirugía Pediátrica. Hospital Universitario La Paz. Madrid., López Santamaría M; Servicio de Cirugía Pediátrica. Hospital Universitario La Paz. Madrid.
Jazyk:	Spanish; Castilian
Zdroj:	Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica [Cir Pediatr] 2018 Apr 20; Vol. 31 (2), pp. 71-75. Date of Electronic Publication: 2018 Apr 20.
Abstrakt:	Aim of the Study: Recommendation of early pulmonary resection in asymptomatic congenital pulmonary airway malformations (CPAMs) is based on the presumed compensatory lung growth during the first months of life. Our aim is to analyze the long-term pulmonary function after lobectomy before and after one year of age using spirometry. Methods: We performed a retrospective review of children who underwent pulmonary lobectomy for CPAM between 2001 and 2016. Patients who were old enough (>5 years) to carry out a spirometry were included in the study and were divided into 2 groups (surgery before or after 12 months of age). Pulmonary function testing values were considered normal if they were >80% of predicted. Main Results: Forty-seven patients underwent pulmonary lobectomy for CPAM, 23 of them met the inclusion criteria and prospectively performed a spirometry. Among them, 7 had surgery before and 16 after one year of age (0.1 vs. 2); being both groups comparable in terms of sex, type of CPAM and surgical approach. Time from surgery until pulmonary function testing was longer in patients who had surgery before one year of age (9.1 vs. 4.6 years, p = 0.003). After correcting results by time from surgery until spirometry, a better FEV1/FVC was found in patients who had surgery after one year of age (90% vs. 77%, p = 0.043). Conclusion: Although spirometry may be influenced by many other variables, these preliminary results do not support the current recommendation of performing early lobectomy in CPAMs. Further studies are required in order to resolve the best age to perform pulmonary lobectomy.
Databáze:	MEDLINE
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