SURGICAL-MANAGEMENT OF CONGENITAL LOBAR EMPHYSEMA

Here in nine patients with congenital lobar emphysema who had been tre ated surgically in the previous 10 years are reported. The ages of the patients at diagnosis ranged from 26 days to 11 months. The six patie nts whose symptoms started in the neonatal period had more severe dysp nea, cyanosis and respiratory distress. Tube thoracostomy was performe d in two of three patients who had been misdiagnosed initially. The af fected side was the left upper lobe in live patients, the right upper lobe in three, and the right middle and upper lobes in one patient. Lo bectomy war performed in all cases. Dysplasia of the bronchial cartila ge war found in six patients and bronchial atresia of the left upper r obe was found in another infant as the etilogic cause of the condition . Although the possibility of conservative management In congenital lo bar emphysema has been reported recently, we believe that surgery is t he treatment of choice in patients who have persistent or progressive, severe respiratory distress in spite of medical treatment.