Surgical management of congenital lobar emphysema: A 15 years experience in a tertiary thoracic surgery unit

Abstract

Backgroundcongenital lobar emphysema is a rare cause of respiratory distress in neonates and infants. It was treated by lobectomy since 1943.The aim of this study was to present our experience in the diagnosis and surgical treatment of congenital lobar emphysema cases and highlight the effect of multi-displinary team work on the outcome. MethodsWe retrospectively analyzed data of patients operated for congenital lobar emphysema at cardiothoracic surgery department, Sohag university hospital over the period of 15 years starting from January 2000 and ending in December 2015. ResultsTotal number of cases was fifty three. Males were 39 (74%) while females were 14 (26%). Mean age was 12 weeks (3 weeks - 15 months). Six patients (11%) had associated cardiac anomalies. Main clinical presentations were acute respiratory distress and recurrent chest infection. Left upper lobe was affected in 35 cases (66%), right upper lobe in 10 cases (19%) and right middle lobe in 8 cases (15%). All cases were subjected to anatomical lobectomy by thoracotomy. One patient was subjected to patent ductus arteriosus ligation simultaneously with left upper lobectomy at the same operative setting. Post operative complications were reported in 8 cases (15%) and one patient of them died from sepsis and respiratory failure (1.9%). Postoperatively, all surviving patients were followed up for one year in the outpatient clinic. Conclusionscongenital lobar emphysema is a life threatening disease. Early diagnosis and surgical management by a multi-displinary team is the golden key for favorable and safe outcome.