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Eur J Cardiothorac Surg 2005;27:658-661
© 2005 Elsevier Science NL
a Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Xenotransplantation Research Center, Cancer Research Institute, Seoul National University College of Medicine, 28 Yongon-Dong, Chongro-Gu, Seoul 110-744, South Korea
b Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
Received 7 September 2004; received in revised form 6 January 2005; accepted 17 January 2005.
* Corresponding author. Tel.: +82 2 760 3161; fax: +82 2 765 7117. (E-mail: ytkim{at}snu.ac.kr).
Objective: The recent development of fetal ultrasonography has allowed for an increasing number of prenatal diagnoses for congenital cystic adenomatoid malformation (CCAM). However, the appropriate surgical timing of these patients has not been studied as of yet. The aim of this study is to suggest a safe strategy for the treatment of CCAM by identifying the relationship between the timing of surgery and postoperative outcome. Methods: Between 1987 and 2003, 40 patients (28 males, 12 females) underwent surgical resection for CCAM. The mean age was 38.6±9.1 (2 days–13 years) months. CCAM was diagnosed by prenatal ultrasonography in eight patients. Early operations were performed in four out of the eight. Operation was deferred until 2–12 months of age for the remaining four patients. Results: Type I CCAM was found in 20 patients, type II in 20 and no patient exhibited type III. Five patients had associated pectus excavatum anomaly. There were no cases of operative mortality. Seventeen minor postoperative complications developed in 16 patients (40.0%): prolonged chest tube drain in 10, wound infection in 4, and 1 case of pneumonia, empyema and pleural space, respectively. The average hospital stay was 11.8 (6–29) days. During the mean follow-up period of 67.5 months, one patient died of accidental aspiration 7 months after operation during the postoperative recovery course of Ravich operation for pectus excavatum. The remaining patients reported doing well with normal physical activity. All five patients who underwent surgery at the age of under 1 month did not exhibit increased postoperative morbidity. Conclusions: We concluded that surgery for CCAM could be safely performed in all age groups with satisfactory long-term outcomes. It is suggested that early elective surgical correction can be recommended for a patient whose diagnosis was made in utero.
Key Words: Congenital cystic adenomatoid malformation • Surgery • Complication • Early postnatal period
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  H. K. Kim, Y. S. Choi, K. Kim, Y. M. Shim, G. W. Ku, K.-M. Ahn, S. I. Lee, and J. Kim Treatment of congenital cystic adenomatoid malformation: should lobectomy always be performed? Ann. Thorac. Surg., July 1, 2008; 86(1): 249 - 253. [Abstract] [Full Text] [PDF]
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 G. Shanmugam Resection for congenital cystic adenomatoid malformation--surgery delayed is surgery denied? Eur. J. Cardiothorac. Surg., August 1, 2005; 28(2): 360 - 361. [Full Text] [PDF]
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Y. T. Kim and J. S. Kim Reply to Shanmugam Eur. J. Cardiothorac. Surg., August 1, 2005; 28(2): 361 - 361. [Full Text] [PDF]
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