Longitudinal follow-up of pulmonary function after lobectomy in childhood - factors affecting lung growth

Nakajima, Chihiro; Kijimoto, Chuichi; Yokoyama, Yuka; Miyakawa, Tomoo; Tsuchiya, Yutaka; Kuroda, Takeshi; Nakano, Masaaki; Saeki, Morihisa

doi:10.1007/s003830050334

Cited by 76 publications

(45 citation statements)

References 4 publications

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“…Ayed and Al-Rowayeh [17] reported no significant changes in spirometric pattern comparing pre-and post-operative spirometries in 14 [18]. In our series, abnormal spirometric patterns were more common than in the above mentioned and were unrelated to the length of follow-up.…”

Section: Discussioncontrasting

confidence: 62%

Muscle-sparing thoracotomy combined with mechanically stapled lung resection for benign lung disorders: functional results and quality of life

et al. 2006

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We set out to review our experience with resection of benign lung lesions performed using mechanical stapling devices via a muscle-sparing thoracotomy, and provide data on long-term morbidity, functional results, and quality of life (QOL). Fifty-two patients with a benign lung disorder were included in the study. All underwent a lung resection with mechanical staplers via a muscle-sparing thoracotomy. Medical records were retrospectively searched for postoperative complications. Nineteen patients (36.5%) also underwent a final follow-up including clinical examination, radiological investigations, functional tests, and assessment of QOL by a standardized questionnaire. No intra-operative complications occurred. The resection was anatomical (lobectomy) in 28 (53%) children and wedge in 25 (47%). Five cases (9.6%) required secondary surgery. Of the 19 children undergoing long-term follow-up, 3 (16%) had musculoskeletal anomalies and 6 (31.5%) respiratory symptoms. All X-rays were normal. Spirometry was abnormal in 9 cases (47.3%). QOL was excellent/good in 17 cases (89.5%) and sufficient in 2 (10.5%). An abnormal spirometric pattern was significantly more frequent in cases with a poorer QOL. In conclusion, stapled resection via a muscle-sparing thoracotomy is a good option to perform lung resections. However, a muscle-sparing approach does not avoid entirely long-term musculoskeletal complications. QOL is good in nearly 90% of cases, but respiratory symptoms and abnormal spirometric function can be found in one third and half of the patients, respectively. An abnormal spirometry is more common in patients with a poorer QOL. Systematic radiological follow-up is unnecessary.

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Section: Discussioncontrasting

confidence: 62%

Muscle-sparing thoracotomy combined with mechanically stapled lung resection for benign lung disorders: functional results and quality of life

et al. 2006

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“…This is corroborated by a study in children aged 1 month-11 yrs who underwent lung lobectomy due to pulmonary cystic disease [42]. Pulmonary function analysis performed over two post-operative years indicated that complete normalisation of pulmonary function can be achieved in children aged ,4 yrs at the time of operation.…”

Section: Discussionmentioning

confidence: 60%

Neoalveolarisation contributes to compensatory lung growth following pneumonectomy in mice

Fehrenbach¹,

Voswinckel²,

Michl³

et al. 2008

European Respiratory Journal

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Regeneration of the gas exchange area by induction of neoalveolarisation would greatly improve therapeutic options in destructive pulmonary diseases. Unilateral pneumonectomy is an established model to remove defined portions of gas exchange area and study mechanisms of compensatory lung growth. The question of whether new alveoli are added to the residual lung after pneumonectomy in mice was addressed.Left-sided pneumonectomy was performed in 11 adult C57BL/6 mice. Alveolar numbers were analysed in lungs fixed at days 6 and 20 after pneumonectomy and in 10 age-matched controls using design-based stereology based on a physical fractionator. Post-fixation lung volume was determined by fluid displacement.Complete restoration of lung volume was observed 20 days after pneumonectomy. Alveolar numbers were significantly increased by 33% in residual right lungs at day 20 in comparison with control right lungs. In control left lungs, an average of 471¡162610 3 alveoli was estimated, 49% of which were regenerated by residual lungs at day 20. Of the newly formed alveoli seen at day 20, 74% were already present at day 6. The present data demonstrate that, in addition to growth in size of existing alveoli, neoalveolarisation contributes to restoration of the gas exchange area in adult mice and is induced early after pneumonectomy.

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“…In naphthaleneinduced injury, selective loss of nonciliated bronchiolar cells occurs without apparent injury to or proliferation of alveolar epithelial cells, whereas in the pneumonectomy model marked hyperplasia and proliferation occurs in both airways and alveoli, involving multiple epithelial and nonepithelial cell types (25,26). Nevertheless, dynamic changes in the same transcription factors were associated with regeneration of the bronchiolar epithelium after both naphthalene injury and pneumonectomy models.…”

Section: Discussionmentioning

confidence: 99%

“…Compensatory lung growth occurs in conducting airways as well as lung parenchyma following unilateral pneumonectomy (25,26). We determined whether the regrowth of bronchiolar epithelium was associated with similar changes in transcription proteins that were observed in ciliated cells during repair after naphthalene injury.…”

Section: Expression Of Sox17 and Sox2 In The Squamous Cells Lining Thmentioning

confidence: 99%

Transdifferentiation of Ciliated Cells during Repair of the Respiratory Epithelium

Park

Wells

Zorn

et al. 2006

Am J Respir Cell Mol Biol

181

174

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Since the lung is repeatedly subjected to injury by pathogens and toxicants, maintenance of pulmonary homeostasis requires rapid repair of its epithelial surfaces. Ciliated bronchiolar epithelial cells, previously considered as terminally differentiated, underwent squamous cell metaplasia within hours after bronchiolar injury with naphthalene. Expression of transcription factors active in morphogenesis and differentiation of the embryonic lung, including ␤-catenin, Foxa2, Foxj1, and Sox family members (Sox17 and Sox2), was dynamically regulated during repair and redifferentiation of the bronchiolar epithelium after naphthalene injury. Squamous cells derived from ciliated cells spread beneath injured Clara cells within 6-12 h after injury, maintaining the integrity of the epithelium. Dynamic changes in cell shape and gene expression, indicating cell plasticity, accompanied the transition from squamous to cuboidal to columnar cell types as differentiation-specific cell markers typical of the mature airway were restored. Similar dynamic changes in the expression of these transcription factors occurred in ciliated and Clara cells during regeneration of the lung after unilateral pneumonectomy. Taken together, these findings demonstrate that ciliated epithelial cells spread and transdifferentiate into distinct epithelial cell types to repair the airway epithelium. Keywords: naphthalene; lung injury; transcription; pneumonectomy; bronchioleThe respiratory tract has an extensive cell surface that is directly exposed to inhaled gases, particles, and pathogens. A complex epithelium lines the airways, mediating gas exchange, mucociliary clearance, host defense, and surfactant homeostasis to maintain lung sterility and stability. While the adult lung is not mitotically active, respiratory epithelial cells can proliferate rapidly after injury to maintain lung structure and function.Models in which relatively rare subsets of nonciliated respiratory epithelial cells located in unique environments play critical roles in lung repair have been proposed (1-5). Krause and coworkers have provided evidence that extrapulmonary, bone marrow-derived cells migrate to the lung, contributing to the repair of the respiratory epithelium after injury (6). From a stochastic view, however, models in which rare progenitor cells account for the rapid and extensive repair of the lung are not compatible with the observed short period of proliferation and rapid restoration of epithelial surfaces that is observed after catastrophic injury caused by infection or toxicants. Rather, the remarkable repair capacity of the lung is more consistent with a model in (Received in original form August 30, 2005 and in final form September 30, 2005) This study was supported by NIH HL56387 (J.A.W.) and HL61646 (J

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Longitudinal follow-up of pulmonary function after lobectomy in childhood - factors affecting lung growth

Cited by 76 publications

References 4 publications

Muscle-sparing thoracotomy combined with mechanically stapled lung resection for benign lung disorders: functional results and quality of life

Muscle-sparing thoracotomy combined with mechanically stapled lung resection for benign lung disorders: functional results and quality of life

Neoalveolarisation contributes to compensatory lung growth following pneumonectomy in mice

Transdifferentiation of Ciliated Cells during Repair of the Respiratory Epithelium

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