SCIENCE & INNOVATION

DIAGNOSIS AND TREATMENT OF CONGENITAL LUNG MALFORMATIONS IN CHILDREN

28.06.2023 International Scientific Journal "Science and Innovation". Series D. Volume 2 Issue 6

Kh.X. Sultanov, M.M. Aliyev, U.X. Tilavov, U.A. Sharipov

Abstract. Congenital lung malformations (CLM) involve defectes of the lungs and bronchial tree such as lung hypoplasy with bronchiectasis, congenital pulmonary airway malformation (CPAM), pulmonary sequestration (PS), bronchogenic cysts, congenital lobar emphysema, and bronchial stenosis (BS). Although symptomatic lesions require surgical resection, the appropriateness of surgery for patients with asymptomatic malformations is a matter of ongoing debate. To review the surgical management of Congenital bronchiectasis (CB) in a pediatric surgery unit over a period of 16 years. Patients and Methods. We retrospectively reviewed the medical records of 79 consecutive children who underwent surgery for CB in our clinic between 2006 and 2022. Results. Seventy-nine patients underwent 83 pulmonary resections during the study period. The mean ages at diagnosis of CB and at the time of surgery were 8.10 ± 4.10 years (range, 1 to 17 years) and 9.70 ± 4.20 years (range, 2 to 18 years), respectively. There were 44 males (55.7%) and 35 females (44.3%). The causes of bronchiectasis were congenital hypoplasy of bronchi (n = 31), secondary bronchiectasis was additional nonspecific pulmonary infection (n = 42) and foreign body aspiration (n = 6). Chest X-rays, bronchography and bronchoscopy (n = 79), chest HRCT (n = 61), angiopulmonography (n = 23) were used, and pulmonary function tests (n = 48) were performed. The types of resections were segmenectomy (26.5%), lobectomy (35.4%), and lobectomy with segmentectomy (17.8%), bilobectomy (8.9%) and pneumonectomy (11.4%). The postoperative status of the patients as follows: “well” in - 49 patients (60.7%), “improved” in 23 patients (29.5%), “worsened” in 6 patients (7.7%). And unfortunately, two patients “died” (2.6%). Conclusions: A radiologic and morphologic evidence of reversal of airway abnormality has been shown in cases of congenital defects of bronchial wall. The morbidity and mortality rates of bronchiectasis surgery are within acceptable ranges. Segmentectomy and lobectomy are well tolerated in children without increase in morbidity and mortality.

Keywords: lung malformations, bronchus, bronchiectasis, airway abnormality, pulmonary resection, children.