The diagnosis and surgical treatment of congenital pulmonary adenomatoid malformation

Abstract

Objective To present the experience of diagnosis and treatment of congenital pulmonary adenomatoid malformation (CPAM) in children. Methods Between November 2006 and November 2009,13 patients aged from 50 days to 13 years at surgery, including 6 males and 7 females, were diagnosed with CPAM and underwent pulmonary resection at this center. Most patients presented respiratory distress and respiratory infections before surgery. Diagnosis was made based on chest radiography and computerized tomography (CT). The patients were performed elective surgeries except 3 patients (less than 2 months old) underwent emergency surgeries. Of the 13 patients, 10 were performed single lobectomies, 2 underwent lobectomies plus segmental resections, and 1 had a marsupialisation of the lung lobe cysts. Pathologic diagnoses were Stocker type 1 CPAM of 8 patients, Stocker type 2 CPAM of 2,type 3 CPAM of 2 and type 4 CPAM of 1. Results No death was noted. Two patients had bronchopleural fistula after surgery, of which 1 was healed after conservative treatments and the other underwent thoracoscopic repair. Mean hospital stay after operation was 9. 7 days. Mean follow-up period was 12. 3 months. The 2 patients underwent lobectomies plus segmental resections had mild activity limitation. Conclusions Antenatal ultrasounography is helpful to diagnose the fetal CPAM. CT is a specific way to diagnose thc postnatal CPAM. Early surgical interventions are beneficial in preventing the development of complications. Key words: Congenital pulmonary adenomatoid malformation; Diagnosis; Surgical procedures,operative