Surgical Management Of Congenital Lobar Emphysema In Neonates: A Systematic Review
Keywords:
Congenital lobar emphysema, thoracotomy, lung resection, neonatal surgery, thoracic surgeryAbstract
Background: Congenital lobar emphysema (CLE) is a rare congenital pulmonary anomaly defined by hyperinflation of a lung lobe, typically presenting with respiratory distress in neonates and infants. Early surgical lobectomy is the definitive treatment. This systematic review synthesizes evidence on clinical presentation, surgical approaches (open vs. minimally invasive), timing, perioperative management, outcomes, and complications.
Methods: A systematic search of PubMed, Scopus, and Cochrane databases was conducted for studies published from 2000 to November 2024. Inclusion criteria were case series and retrospective studies involving neonates (<28 days) undergoing surgery for CLE. Data were extracted on demographics, lobe involvement, surgical technique, perioperative care, complications, and long-term outcomes.
Results: Twenty-two studies comprising 134 neonates were included. The most commonly affected lobe was the left upper lobe (64%), with a male predominance (66%). Open thoracotomy was the standard approach in >90% of cases. Early intervention (<14 days) was associated with shorter hospital stays and fewer complications. Complication rates were low (<10%), and long-term respiratory outcomes were excellent.
Conclusion: Surgical lobectomy remains the gold standard for managing symptomatic CLE in neonates. Open thoracotomy continues to dominate, although video-assisted thoracoscopic surgery (VATS) is a viable alternative in experienced centers. Early surgical intervention improves outcomes. Future multicenter prospective studies are needed.
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