Childhood Pneumonectomies: Two Decades' Experience of a Referral Center

Çiftçi, Arbay Ö.; Karnak, İbrahìm; Ekinci, Saniye; Tanyel, Feridun Cahit; Şenocak, Mehmet Emìn

doi:10.1055/s-0032-1323159

Cited by 6 publications

(5 citation statements)

References 26 publications

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“…One quarter of patients in this series experienced postoperative morbidity attributed to pneumonectomy including 1 death. Rates of bleeding and pneumonia or empyema are consistent with existing series of children who underwent pneumonectomy for mostly benign disease 4–7,14 . In a series of 4 extrapleural pneumonectomies for pediatric malignancies, 1 patient had a postoperative arrhythmia and 1 had a paralyzed vocal cord 8 .…”

Section: Discussionsupporting

confidence: 76%

“…Surgical margins were positive in 14 patients (37%). There was no association between diagnosis and margin status (P ¼ 0.60) Patients required postoperative mechanical ventilation for a median of 0 days (0-1), intensive care for 2 days (1-3), and hospitalization for 8 days (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). Postoperative complications occurred in 10 patients (26%) and included chronic chest pain, vocal cord dysfunction (n ¼ 2 each), death, hemothorax, chylothorax, pneumonia, symptomatic contralateral pleural effusion, and pericarditis (n ¼ 1 each).…”

Section: Resultsmentioning

confidence: 99%

“…While pneumonectomy in adult patients with cancer is well studied, little is known about oncologic indications and outcomes for pediatric pneumonectomy, as most of these procedures in children are performed for benign indications such as postinfectious bronchiectasis 4–7 . Limited data in this nononcologic pediatric population suggest the mortality rate is lower than reported in adults; however, 1 in 4 children experienced a major complication in existing literature.…”

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confidence: 99%

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Pneumonectomy for Pediatric Tumors—a Pediatric Surgical Oncology Research Collaborative Study

et al. 2020

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Objective: To describe utilization and long-term outcomes of pneumonectomy in children and adolescents with cancer. Summary Background Data: Pneumonectomy in adults is associated with significant morbidity and mortality. Little is known about the indications and outcomes of pneumonectomy for pediatric tumors. Methods: The Pediatric Surgical Oncology Research Collaborative (PSORC) identified pediatric patients <21 years of age who underwent pneumonectomy from 1990 to 2017 for primary or metastatic tumors at 12 institutions. Clinical information was collected; outcomes included operative complications, long-term function, recurrence, and survival. Univariate log rank, and multivariable Cox analyses determined factors associated with survival. Results: Thirty-eight patients (mean 12 AE 6 yrs) were identified; median (IQR) follow-up was 19 (5-38) months. Twenty-six patients (68%) underwent pneumonectomy for primary tumors and 12 (32%) for metastases. The most frequent histologies were osteosarcoma (n ¼ 6), inflammatory myofibroblastic tumors (IMT; n ¼ 6), and pleuropulmonary blastoma (n ¼ 5). Median postoperative ventilator days were 0 (0-1), intensive care 2 (1-3), and hospital 8 (5-16). Early postoperative complications occurred in 10 patients including 1 death. Of 25 (66%) patients alive at 1 year, 15 reported return to preoperative pulmonary status. All IMT patients survived while all osteosarcoma patients died during follow-up. On multivariable analysis, metastatic indications were associated with nonsurvival (HR ¼ 3.37, P ¼ 0.045) Conclusion: This is the largest review of children who underwent pneumonectomy for cancer. There is decreased procedure-related morbidity and mortality than reported for adults. Survival is worse with preoperative metastatic disease, especially osteosarcoma.

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Section: Discussionsupporting

confidence: 76%

Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

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Pneumonectomy for Pediatric Tumors—a Pediatric Surgical Oncology Research Collaborative Study

et al. 2020

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“…This study included various etiology of destroyed lung and concluded that the morbidity and mortality rates of pneumonectomy are acceptable for selected and well-prepared children [ 4 ]. In another evaluation, a study of pre- and postoperative characteristics of 20 children who underwent pneumonectomy for different etiologies showed that correct selection of indications, intensive preoperative rehabilitation with eradication of infection, careful execution of anesthetic and surgical procedures, early management of complications, and long-term support including pulmonary physiotherapy are essential conditions to decrease morbidity and mortality rates of pneumonectomy in child [ 9 ]. These risk factors for mortality in children following pneumonectomy were evaluated by Verónica Giubergia et al.…”

Section: Discussionmentioning

confidence: 99%

Pneumonectomy in a child due to belated diagnosis of foreign body aspiration: a case report

et al. 2021

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Introduction With early diagnosis, fiberoptic or rigid bronchoscopy methods are the gold standard in the management of tracheobronchial foreign body. Otherwise, nonrecognized bronchial foreign bodies cause irreversible damage to the airways and lungs. The deficiency of the health system noted in many developing countries such as Madagascar, combined with the fundamental problem relating to children’s conditions, which are determined by social and educational factors, makes it almost impossible to provide early and appropriate management of the penetration syndrome. Case presentation An 11-year-old Malagasy female patient was referred to our hospital for an investigation of the etiology of the patient’s hemoptysis. The investigations revealed a localized bronchiectasis and atelectasis due to a foreign body obstructing the left main bronchus. Based on the hemoptysis and left lung almost destroyed by an occlusive lesion within, we decided to proceed with left pneumonectomy. A retrospective interrogation revealed a choking episode 4 years prior in elementary school after the child sucked on a pen cap and involuntarily aspirated it. Two years after the pneumonectomy, our patient was doing well and was asymptomatic. Conclusion In this case report, we describe a rare case of a late presentation of foreign body aspiration that resulted in a left pneumonectomy in a child. Despite our favorable results, pneumonectomy must be the preferred last option. Preventive actions remain the optimal approach.

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“…No cases of pneumonectomy for pulmonary lymphangiectasia have been previously reported in a newborn. Yalcin et al (20) recently reported their experience of pneumonectomies of childhood involved a case of congenital pulmonary lymphangiectasia. But their patients were 8 yr old (0.5 to 17 yr) on a median age.…”

Section: Discussionmentioning

confidence: 99%

Pneumonectomy Case in a Newborn with Congenital Pulmonary Lymphangiectasia

et al. 2014

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Congenital pulmonary lymphangiectasia (CPL) is a rare lymphatic pulmonary abnormality. CPL with respiratory distress has a poor prognosis, and is frequently fatal in neonates. We report a case of pneumonectomy for CPL in a newborn. An infant girl, born at 39 weeks' after an uncomplicated pregnancy, exhibited respiratory distress 1 hr after birth, which necessitated intubation and aggressive ventilator care. Right pneumonectomy was performed after her symptoms worsened. Histologic examination indicated CPL. She is currently 12 months old and developing normally. Pneumonectomy can be considered for treating respiratory symptoms for improving chances of survival in cases with unilateral CPL.Graphical Abstract

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Childhood Pneumonectomies: Two Decades' Experience of a Referral Center

Cited by 6 publications

References 26 publications

Pneumonectomy for Pediatric Tumors—a Pediatric Surgical Oncology Research Collaborative Study

Pneumonectomy for Pediatric Tumors—a Pediatric Surgical Oncology Research Collaborative Study

Pneumonectomy in a child due to belated diagnosis of foreign body aspiration: a case report

Pneumonectomy Case in a Newborn with Congenital Pulmonary Lymphangiectasia

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