RESUMEN
PURPOSE: The aim of the study was to define the details of the history and clarify the cause for respiratory distress, justify the need for surgical correction and suggest a rational operative technique for patients with lung aplasia. METHODS: Our experience with the management of 9 patients with lung aplasia and 1 patient with lung agenesis in the period from 1985 to 2004 is presented. All 10 patients were referred for respiratory distress. A detailed study of clinical symptoms and the data from X-ray, computed tomography (CT), tracheobronchoscopy and digital subtraction angiography (DSA) suggested that all patients had different degrees of mediastinal shift and heart rotation, tracheal kinking and compression of the aortic arch and innominate artery or emphysema of a single lung. Two of the patients required operation. RESULTS: We performed ipsilateral cephalad translocation of the diaphragm which resulted in complete recovery from respiratory distress and a significant improvement in tolerance of physical exercise in both patients. The good results in these patients were followed up for 8 and 2 years, respectively. CONCLUSIONS: We suggest that ipsilateral translocation of the diaphragm could be a useful alternative to unsuccessful symptomatic treatment in patients with lung aplasia.
Asunto(s)
Enfermedades Pulmonares , Pulmón/anomalías , Neumonectomía/métodos , Angiografía de Substracción Digital , Broncografía , Broncoscopía , Niño , Preescolar , Diagnóstico Diferencial , Femenino , Estudios de Seguimiento , Humanos , Lactante , Enfermedades Pulmonares/congénito , Enfermedades Pulmonares/diagnóstico , Enfermedades Pulmonares/cirugía , Masculino , Estudios Retrospectivos , Tomografía Computarizada por Rayos X , Resultado del TratamientoAsunto(s)
Malformaciones Arteriovenosas/diagnóstico , Enfermedades Intestinales/diagnóstico , Intestino Grueso/irrigación sanguínea , Adolescente , Malformaciones Arteriovenosas/complicaciones , Malformaciones Arteriovenosas/cirugía , Niño , Preescolar , Diagnóstico Diferencial , Femenino , Hemorragia Gastrointestinal/congénito , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/etiología , Hemorragia Gastrointestinal/cirugía , Humanos , Lactante , Enfermedades Intestinales/complicaciones , Enfermedades Intestinales/congénito , Enfermedades Intestinales/cirugía , Intestino Grueso/cirugía , Masculino , RecurrenciaRESUMEN
From 1981 till 1993 yr. 144 children with the cystic pulmonary hypoplasia resided in the clinic for treatment. Except the generally accepted methods of instrumental diagnosis for 19 patients the digital subtraction angio-pulmonography was conducted for the diagnosis ascertainment. Bilateral lesion of lungs was observed in 14 patients, one of whom have died without operative treatment conduction. The surgical treatment was done for 130 patients. The combined operations were performed, as well as the classic resection of lungs. One patient was observed with broncho-mediastinal fistula, which have appeared 5 years after operation and one more was reoperated. All the patients survived the operation were discharged from hospital in satisfactory condition.