Eight patients with congenital lobar emphysema and eight with congenital cystic adenomatoid malformations were operated upon between 1970 and 1978. A lobectomy was performed in all cases. At follow-up after 3 to 11 years all of the patients without concomitant disease or malformations were subjectively well with a physical performance equal to those of their playmates. Lung function tests indicated lung volumes of about 90% of predicted normal values, indicating some compensatory growth of the remaining lung tissue. Functional impairment owing to loss of lung tissue or residual disease was ruled out by the existence of a normal working capacity and maintenance of the alveolar gas exchange during intense exercise.

No abstract

Low birthweight and associated anomalies are important risk factors in patients with esophageal atresia. Gastroesophageal reflux is also a common problem in these patients and can lead to serious complications. The aim of this retrospective study was to analyse complications and mortality in 110 patients treated for esophageal atresia between January 1971-December 1987, in order to determine what role reflux may play. Symptoms of reflux were common in most patients during the first years of life. In some cases the symptoms were serious and even caused some late deaths by aspiration. The overall mortality was 12% (13/110). Early mortality (six patients) was caused by prematurity and associated anomalies, whereas late mortality often was caused by aspiration or other respiratory complications. Patients who had been operated with a circular myotomy showed more complications, but did not show a higher mortality rate than the remainder. This study confirms the importance of identifying patients with reflux at an early stage in order to prevent serious complications and mortality.

No abstract

A 17-month-old girl had a neuroblastoma with high preoperative urinary excretion of norepinephrine and a manifest hypertension. She developed during and after surgery circulatory complications similar to those seen when a pheochromocytoma is removed without prior sympathetic blockade. This complication in connection with a neuroblastoma has not been described previously. This case points to the necessity of careful preoperative evaluation of the circulatory function in cases of neuroblastomas in children. The paediatric surgeon and the anaesthetist should take a preoperative sympathetic blockade into consideration.