Respiratory Morbidity Among Children Undergoing Surgical Resection for a Congenital Lung Malformation.

Autor: Halbert-Elliott KM; Department of Surgery, Division of General Pediatric Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA., Sescleifer AM; Department of Surgery, Division of General Pediatric Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA., Mogayzel PJ; Department of Pediatrics, Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA., Kunisaki SM; Department of Surgery, Division of General Pediatric Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Jazyk: angličtina
Zdroj: Pediatric pulmonology [Pediatr Pulmonol] 2024 Nov 29, pp. e27420. Date of Electronic Publication: 2024 Nov 29.
DOI: 10.1002/ppul.27420
Abstrakt: Background: Congenital lung malformations (CLMs) are the most common condition requiring lung surgery in children. Although surgical resection is generally well tolerated in the immediate postoperative period, long-term outcomes are not well studied. In this paper, we sought to define the risk of childhood respiratory morbidity, specifically asthma and pneumonia, in patients who underwent CLM resection.
Methods: After IRB approval, a retrospective study was conducted on all pediatric CLM resections performed at a single tertiary care children's hospital between January 2013 and December 2022. The primary outcome measures were the diagnosis of asthma and/or pneumonia more than 30 days after resection. Clinical and demographic characteristics were evaluated in univariate analysis and multivariable logistic regression as appropriate (p < 0.05).
Results: Of the 54 patients who underwent CLM resection, 36 (67%) met inclusion criteria. The median age at resection was 6.2 months (IQR: 4.3-9.0), and the median follow-up period was 3.7 years (IQR: 1.7-5.7). Twelve were subsequently diagnosed with asthma at a median age of 3.3 years (IQR: 2.1-4.5). These observed asthma rates were significantly higher than expected when compared to nonlung surgery controls (33% vs. 6%, p < 0.01). Seven (21%) children were diagnosed with pneumonia, but this was not significantly different.
Conclusion: These data suggest that children undergoing lung resection for a CLM may be at an increased risk for the development of early childhood asthma. Given the potential implications for preoperative counseling and postoperative follow-up, multicenter studies to validate these findings are warranted.
(© 2024 Wiley Periodicals LLC.)
Databáze: MEDLINE
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