170 * PULMONARY HYPOPLASIA

Abstract

Objectives: To determine the results of surgical treatment of lung hypoplasia in children and adults. Methods: In our clinic over the last 30 years, 21 patients with pulmonary hypoplasia were operated upon, which amounted to 2.1% of the operated congenital lung disease. The first signs of pulmonary hypoplasia in 61.9% of patients were manifested from early childhood. With suspected pulmonary hypoplasia, bronchoscopy, computed tomography and angiography were performed. Endoscopic evidence of inflammation was found in only one (5.6%) patient; in the remainder, varying degrees of prevalence and severity of endobronchitis were revealed. Pulmonary hypoplasia was localized in the left lung in 15 (71.4%) cases. All the patients underwent surgery to remove the hypoplastic lung. Adult patients had a longer history of the disease, so that they all had dense and extensive adhesions in the pleural space. This led to an increase in morbidity and length of operation, requiring particularly careful selection of vessels and bronchi. In two cases (9.5%), due to the pleural thickening, and adhesions covering the heart and lung root, as well as mediastinal shift, it was necessary to do a transpericardial pneumonectomy. All patients were discharged in satisfactory condition. Results: In the late period from 1 year to 14 years we examined 12 (57.1%) of the operated patients. We found that the removal of hypoplastic lung leads to the reduction of inflammatory changes in the bronchial tree up to their complete disappearance. Unsatisfactory results were not observed. Conclusions: Early surgical treatment of hypoplastic lung prevents the development of suppurative processes, pathological shunting of blood and pulmonary hypertension. The risk of postoperative complications increases with the duration of the clinical symptoms and the age of the patient.