Abstract
Aim of Study The aim of this study was to review our experience of postnatal investigations and
management of congenital lung lesions.
Methods All children with antenatal diagnosis undergoing surgical management were identified
from hospital records. Antenatal diagnosis and serial antenatal ultrasound findings
were noted, postnatal chest X-ray (CXR) and computed tomographic (CT) scan were reviewed.
Pearson correlation coefficient (r) was used to look into relation between CT scan and per-operative findings. Surgical
management and outcome of these lesions were assessed.
Results A total of 38 children were identified between January 2000 and December 2011; 22
were males and 16 were females. The mean gestational age at diagnosis was 21 weeks
(range18 to 26 weeks). Five children showed complete resolution antenatally. Four
children were symptomatic at birth. Postnatal CXR showed an abnormality in only 17
infants. CT scan with three-dimensional (3D) reconstructions was performed at the
mean age of 7.7 months (range 1 day to 42 months). CT scan correlated well with per-operative
findings and provided adequate anatomical information r = 0.98. Open thoracotomy and lobectomy/excision was performed in 23, and 15 had thoracoscopic
lobectomy/excision. The mean age of operation was 18 months (range 2 days to 96 months).
Twenty patients had signs of recurrent preoperative infection with pleural adhesions
and hilar thickening resulting in conversion of 10 thoracoscopic cases to open surgery.
Histology confirmed 26 congenital cystic adenomatoid malformations, 2 hybrid lesions,
7 sequestrations, and 3 bronchopulmonary malformations.
Conclusions Antenatal resolution and normal postnatal CXR are not reliable indicators of resolution
of the lesion. Early postnatal CT scan preferably with 3D reconstruction and early
surgical treatment are suggested, as delaying the operation may result in repeated
infection making thoracoscopic approach more difficult.
Keywords
lung - CCAM - congenital - cyst
