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Medium and long term follow-up in children operated for bronchial dilations: retrospective study and report of 65 cases

H. Fran├žois-Coridon, E. Aubry, A. Deschildre, C. Thumerelle, R. Sfeir, R. Matran, R. Besson, M. Bonnevalle

Jeanne de Flandre Hospital, Lille, France

 

ABSTRACT

Introduction: Bronchial dilations (BD) in children require sometimes surgical treatment. We studied the clinical evolution and respiratory function at medium and long term in children operated for BD. It is a retrospective study of 65 children (67 interventions) operated from 1997 to 2008.

Material and methods: All the children were re-examined in consultation, except 7 lost to follow-up and one deceased. The BD were classified in 2 groups: 62% acquired BD (post-infectious, syndrome of the median lobe, intra bronchial foreign body) and 38% of them secondary to a congenital disease (mucoviscidosis, cilliary dyskinesia, immune deficiency).

Results: The average age at intervention was 8,36 years. The lesions prevailed in the median lobe (28%) and left lower lobe (27%). There were 51 lobectomies, one pneumonectomy, 6 segmentectomy and multiple resections. At one year after surgery, 64% of the children had reduced their medical treatment, 27% had an identical treatment and 7% had to reinforce their treatment. The pediatric pneumologist judged that 77% of the children either were improved or cured and 11% unchanged. The clinical parameters were compared statistically between the pre and postoperative periods. The functional respiratory tests in the 1st year after surgery and late tests were compared statistically with the preoperative FRT. The clinical results and FRT differed according to the 2 groups of patients. The average age at the late consultation was 14, 37 years with an average follow-up of 6,3 years. The majority of the children practice sports (88%), 63% never repeated a year in school. The scar was considered beautiful or correct in 93% of the cases. This consultation discovered 2 thoracogenic scoliosis and 4 winged scapulas.

Conclusion: The long-term results of the interventions for BD are satisfactory (reducing of the treatment, clinical improvement). The long-term follow-up of these children needs special attention, especially concerning development of the respiratory capacity (FRT) and orthopaedic sequelae after thoracotomy (scoliosis).

 

Key words: bronchial dilatations, lobectomy, long-term follow-up, FRT