Base de dados : MEDLINE
Pesquisa : C08.381.150 [Categoria DeCS]
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[PMID]:29390425
[Au] Autor:Xia B; Hong C; Tang J; Liu C; Yu G
[Ad] Endereço:Department of Maternal-Fetal Medicine, Guangdong Women and Children Hospital, Guangzhou, China.
[Ti] Título:A "blind" vascular ring in association with congenital cystic adenomatoid malformation: A case report.
[So] Source:Medicine (Baltimore);96(51):e8915, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: The occurrence of congenital cystic adenomatoid malformation (CCAM) and vascular ring (VR) is extremely rare. PATIENT CONCERNS: We present a case of left CCAM with VR consisting of a left aortic arch and right descending aorta with left tracheal compression causing atelectasis. DIAGNOSES: A high-risk male neonate with the diagnosis of left CCAM was diagnosed at 20 weeks gestational age by antenatal ultrasound. Chest CT revealed multiple cysts in the left inferior lung. Cardiac CT showed VR consisting of a left aortic arch and right descending aorta with left tracheal compression causing atelectasis. INTERVENTIONS: left inferior lobectomy was performed. Cardiac CT showed VR consisting of a left aortic arch and right descending aorta with left tracheal compression causing atelectasis. Descending aorta transposition was performed. OUTCOMES: The patient recovered smoothly and remained asymptomatic during the 12-months of postoperative follow-up period. LESSONS: We report this rare case of CCAM with VR consisting of left aortic arch and right descending aorta with left tracheal compression causing atelectasis. From the findings of this report, early surgical treatment is recommended. Although the prognosis after surgery remained good, second surgery can be avoided if VR was detected early.
[Mh] Termos MeSH primário: Malformação Adenomatoide Cística Congênita do Pulmão/diagnóstico
Anel Vascular
[Mh] Termos MeSH secundário: Anormalidades Múltiplas/diagnóstico
Anormalidades Múltiplas/diagnóstico por imagem
Anormalidades Múltiplas/cirurgia
Adulto
Malformação Adenomatoide Cística Congênita do Pulmão/complicações
Malformação Adenomatoide Cística Congênita do Pulmão/diagnóstico por imagem
Malformação Adenomatoide Cística Congênita do Pulmão/cirurgia
Diagnóstico Diferencial
Feminino
Seres Humanos
Recém-Nascido
Gravidez
Atelectasia Pulmonar/etiologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008915


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[PMID]:29290632
[Au] Autor:Markou GA; Dafereras G; Poncelet C
[Ad] Endereço:Department of Obstetrics and Gynecology, Rene-Dubos Hospital, Cergy-Pontoise, France.
[Ti] Título:Congenital Cystic Adenomatoid Malformation Diagnosed During First-Trimester Ultrasound Scan.
[So] Source:Am J Case Rep;19:1-4, 2018 Jan 01.
[Is] ISSN:1941-5923
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND Congenital cystic adenomatoid malformation (CCAM) is mostly reported from the second trimester of pregnancy. We report a case of a microcystic type of CCAM that was suggested by routine ultrasound examination at a gestational age of 12 weeks. CASE REPORT First-trimester ultrasound screening revealed the presence of a hyperechoic image that occupied the whole of the right lung, without no other any associated complications. The cardiac and aorta deviations with diaphragmatic eversion associated with a poly-hydramnios had subsequently appeared. The diagnosis of CCAM was confirmed histologically after termination of the pregnancy at 25 weeks of gestation. CONCLUSIONS CCAM may occur at a very early stage of fetal lung development.
[Mh] Termos MeSH primário: Malformação Adenomatoide Cística Congênita do Pulmão/diagnóstico por imagem
Primeiro Trimestre da Gravidez
Ultrassonografia Pré-Natal
[Mh] Termos MeSH secundário: Aborto Terapêutico
Adulto
Malformação Adenomatoide Cística Congênita do Pulmão/cirurgia
Diagnóstico Diferencial
Feminino
Seres Humanos
Gravidez
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180205
[Lr] Data última revisão:
180205
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180102
[St] Status:MEDLINE


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[PMID]:28739257
[Au] Autor:Kim JH; Yamaori S; Tanabe T; Takagi M; Matsubara T; Okamoto M; Kimura S; Gonzalez FJ
[Ad] Endereço:Department of Pharmacology, School of Medicine, Institute of Health Sciences, Gyeongsang National University, Jinju 52727, Republic of Korea; Laboratory of Metabolism, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA. Electronic address: j
[Ti] Título:Lack of epithelial PPARγ causes cystic adenomatoid malformations in mouse fetal lung.
[So] Source:Biochem Biophys Res Commun;491(2):271-276, 2017 Sep 16.
[Is] ISSN:1090-2104
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Peroxisome proliferator-activated receptor-γ (PPARγ) plays an important role in lipid and glucose metabolism. In this study, the function of PPARγ on lung development was investigated. Lung-specific Pparg conditional knockout mice (Pparg ) were developed using Cre-Lox system. Pparg mice showed abnormal lung development with enlarged airspaces and followed by increase of apoptotic cells at E14.5 to E18.5. Gene analysis revealed that expression of Pmaip1, a gene related to apoptosis, was significantly increased while expression of Retnla, a gene related to anti-apoptosis, was dramatically decreased in the fetal lung (E14.5) of Pparg mice. In addition, expression of Pthlh, a gene phenotypically expressed in the congenital cystic adenomatoid malformation (CCAM), was increased at E14.5 to E18.5 in the lung of Pparg mice. Cell culture studies revealed that PPARγ could bind to promoter region of Pthlh gene as a repressor in the immortalized mouse lung epithelial cell line MLE-15. Surprisingly, phenotypic changes in MLE-15-shPparg cells, stably transfected with shPparg plasmid, were similar to the Pparg mice model. In addition, MLE-15-shPparg cells were easily detached from the cultured plate when cold phosphate buffered saline was applied. Furthermore, expression of Cdh1, a gene related to cell adhesion, was significantly reduced in the MLE-15-shPparg cells. Taken together, PPARγ may play an important role in fetal lung development via alveolar cell-to-cell adhesion system.
[Mh] Termos MeSH primário: Malformação Adenomatoide Cística Congênita do Pulmão/genética
Células Epiteliais/metabolismo
Regulação da Expressão Gênica no Desenvolvimento
Peptídeos e Proteínas de Sinalização Intercelular/genética
PPAR gama/genética
Proteínas Proto-Oncogênicas c-bcl-2/genética
[Mh] Termos MeSH secundário: Animais
Apoptose
Sítios de Ligação
Proteínas Cdh1/genética
Proteínas Cdh1/metabolismo
Adesão Celular
Linhagem Celular Transformada
Malformação Adenomatoide Cística Congênita do Pulmão/metabolismo
Malformação Adenomatoide Cística Congênita do Pulmão/patologia
Embrião de Mamíferos
Células Epiteliais/patologia
Feto
Genes Reporter
Peptídeos e Proteínas de Sinalização Intercelular/metabolismo
Luciferases/genética
Luciferases/metabolismo
Pulmão/metabolismo
Pulmão/patologia
Camundongos
Camundongos Knockout
PPAR gama/deficiência
Proteína Relacionada ao Hormônio Paratireóideo/genética
Proteína Relacionada ao Hormônio Paratireóideo/metabolismo
Cultura Primária de Células
Regiões Promotoras Genéticas
Ligação Proteica
Proteínas Proto-Oncogênicas c-bcl-2/metabolismo
Mucosa Respiratória/metabolismo
Mucosa Respiratória/patologia
Transdução de Sinais
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Cdh1 Proteins); 0 (Fzr1 protein, mouse); 0 (Intercellular Signaling Peptides and Proteins); 0 (PPAR gamma); 0 (Parathyroid Hormone-Related Protein); 0 (Pmaip1 protein, mouse); 0 (Proto-Oncogene Proteins c-bcl-2); 0 (Retnla protein, mouse); EC 1.13.12.- (Luciferases)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170824
[Lr] Data última revisão:
170824
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170726
[St] Status:MEDLINE


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[PMID]:28584070
[Au] Autor:Cook J; Chitty LS; De Coppi P; Ashworth M; Wallis C
[Ad] Endereço:Department of Paediatric Respiratory Medicine, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
[Ti] Título:The natural history of prenatally diagnosed congenital cystic lung lesions: long-term follow-up of 119 cases.
[So] Source:Arch Dis Child;102(9):798-803, 2017 Sep.
[Is] ISSN:1468-2044
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: A paucity of evidence regarding the natural history of congenital pulmonary airway malformations (CPAMs) and pulmonary sequestration (PS) has resulted in a divergence in management strategy of asymptomatic cases. METHODS: We describe the long-term clinical course of 119 children diagnosed with these lesions treated at Great Ormond Street Hospital (GOSH). Cases were identified via the GOSH patient database. Study entry required the identification of a cystic lung lesion on prenatal ultrasound and confirmation of CPAM/PS on postnatal CT imaging. Patients followed up for at least 5 years were included. RESULTS: 51 (43%) patients were managed surgically; 8 (6.7%) as an emergency during the neonatal period, 6 (5.1%) electively due to concerning features on CT scan, 20 (17%) following medical advice, 1 (0.8%) following a severe respiratory infection and in 5 (4.2%) the indication was unclear. The indication in 11 (9.2%) was recurrent respiratory infection and median age at surgery was 1.6 years (range 0.4 to 4.6 years). No cases of malignancy were identified on histological examination of resected lesions. 68 (57%) patients were managed conservatively for a median period of 9.9 years (range 5.2 years to 18 years). Seven (10%) were discharged, one was followed-up elsewhere (1.5%) and eight (11%) were lost to follow-up. In four patients (5.9%), the lesion resolved spontaneously. 52 (76%) continue to be followed-up and remain asymptomatic. CONCLUSIONS: This is one of the largest case series documenting the natural history of CPAMs and PS following a prenatal diagnosis and demonstrates that conservative management is a reasonable option in selected cases.
[Mh] Termos MeSH primário: Sequestro Broncopulmonar/diagnóstico por imagem
Malformação Adenomatoide Cística Congênita do Pulmão/diagnóstico por imagem
[Mh] Termos MeSH secundário: Fatores Etários
Sequestro Broncopulmonar/complicações
Sequestro Broncopulmonar/patologia
Sequestro Broncopulmonar/cirurgia
Malformação Adenomatoide Cística Congênita do Pulmão/complicações
Malformação Adenomatoide Cística Congênita do Pulmão/patologia
Malformação Adenomatoide Cística Congênita do Pulmão/cirurgia
Feminino
Seguimentos
Seres Humanos
Recém-Nascido
Masculino
Pneumotórax/etiologia
Gravidez
Prognóstico
Infecções Respiratórias/etiologia
Infecções Respiratórias/cirurgia
Tomografia Computadorizada por Raios X/métodos
Ultrassonografia Pré-Natal/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170607
[St] Status:MEDLINE
[do] DOI:10.1136/archdischild-2016-311233


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[PMID]:28567181
[Au] Autor:Mahmood H; Plumb A; Vega R; Windsor A
[Ad] Endereço:Princess Alexandra Hospital, Hamstel Road, Harlow, CM20 1QX, UK.
[Ti] Título:Incidental finding - the discovery of a bronchopulmonary foregut malformation through investigations for Crohn's disease.
[So] Source:J Radiol Case Rep;11(4):10-19, 2017 Apr.
[Is] ISSN:1943-0922
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Pulmonary sequestration (PMS) is a rare bronchopulmonary malformation. It has an incidence of between 0.15% to 1.7%. Likewise, cystic adenomatoid malformation (CCAM) is another relatively rare category of a bronchopulmonary malformation with a reported incidence of between 1 in 25,000 to 1 in 35,000. Moreover, a bronchopulmonary malformation with features allied to both of these forms is considered an even rarer entity. In general, bronchopulmonary malformations present with a range of non-specific symptoms. Radiological features can be non-specific yet distinctive when related to clinical features. Ultimately, definitive diagnosis depends upon histological assessment of lung tissue. We present an adult female with radiological features of both pulmonary sequestration and cystic adenomatoid malformation. This was an incidental finding unrelated to the patients presenting complaint. This case highlights the importance of using a structured and systematic approach when interpreting medical imagery.
[Mh] Termos MeSH primário: Sequestro Broncopulmonar/diagnóstico por imagem
Doença de Crohn/diagnóstico por imagem
Malformação Adenomatoide Cística Congênita do Pulmão/diagnóstico por imagem
[Mh] Termos MeSH secundário: Anormalidades Múltiplas
Adulto
Colonoscopia
Angiografia por Tomografia Computadorizada
Diagnóstico Diferencial
Feminino
Seres Humanos
Achados Incidentais
Imagem por Ressonância Magnética
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170602
[St] Status:MEDLINE
[do] DOI:10.3941/jrcr.v11i4.3002


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[PMID]:28165443
[Au] Autor:Selimovic A; Hasanbegovic E; Mujicic E; Milisic S; Haxhija E; Karavdic K; Pilav A
[Ad] Endereço:Department of Pulmonology, Pediatric Clinic, Sarajevo, Bosnia and Herzegovina.
[Ti] Título:Video-assisted thoracoscopic lobectomy for congenital cystic adenomatoid malformations.
[So] Source:Med Glas (Zenica);14(1):111-116, 2017 Feb 01.
[Is] ISSN:1840-2445
[Cp] País de publicação:Bosnia and Herzegovina
[La] Idioma:eng
[Ab] Resumo:Aim The aim was to show rare cases of congenital cystic adenomatoid malformation (CCAM) and the manner of its surgical treatment with video-assisted thoracoscopic surgery (VATS). Methods Two male and one female child, 7, 4 and 3 years of age were treated for symptoms of cough and high temperature in district hospitals. In all three children laboratory blood tests and chest radiography were done. Auscultatory findings showed the presence of pneumonia. Children were treated with appropriate doses of antibiotics. After the rehabilitation of inflammation, they were sent to the University Clinical Center Sarajevo, where video-assisted thoracoscopic lobectomy (VATS) was indicated after computerized tomography (CT). Results Chest CT scan pointed to the CCAM and pulmonary sequestration (PS) changes to the lungs. This has required surgery lobectomy of an affected part of the lungs. In two children with PS, the aberrant systemic artery came from the most proximal part of aorta abdominals, the third patient did not have an anomalous artery. Conclusion VATS lobectomy is an alternative to the traditional thoracotomy for the treatment of CCAM and PS, however, it should be investigated in the future for its safety and effectiveness.
[Mh] Termos MeSH primário: Malformação Adenomatoide Cística Congênita do Pulmão/diagnóstico por imagem
Malformação Adenomatoide Cística Congênita do Pulmão/cirurgia
Cirurgia Torácica Vídeoassistida/métodos
[Mh] Termos MeSH secundário: Criança
Pré-Escolar
Feminino
Seres Humanos
Masculino
Estudos Retrospectivos
Tomografia Computadorizada por Raios X
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170606
[Lr] Data última revisão:
170606
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170207
[St] Status:MEDLINE
[do] DOI:10.17392/889-16


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[PMID]:28079822
[Au] Autor:Fan D; Wu S; Wang R; Huang Y; Fu Y; Ai W; Zeng M; Guo X; Liu Z
[Ad] Endereço:aFoshan Fetal Treatment Center bDepartment of Obstetrics, Southern Medical University Affiliated Maternal & Child Health Hospital of Foshan, Foshan, Guangdong cDepartment of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China.
[Ti] Título:Successfully treated congenital cystic adenomatoid malformation by open fetal surgery: A care-compliant case report of a 5-year follow-up and review of the literature.
[So] Source:Medicine (Baltimore);96(2):e5865, 2017 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Congenital cystic adenomatoid malformation (CCAM) is a rare hamartomatous cystic lesion. Open fetal surgery currently provides a potential therapeutic option for management of a fetus with CCAM diagnosis. CASE SUMMARY: A 22-year-old G2P0 woman presented at (Equation is included in full-text article.)weeks' gestation for evaluation of a fetus with a left lung lesion and diagnosed as CCAM at (Equation is included in full-text article.)weeks' gestation. Open fetal surgery was performed to resection the lesion at (Equation is included in full-text article.)weeks' gestation under deep maternal general anesthesia. The mother presented at (Equation is included in full-text article.)weeks after open fetal surgery with preterm premature rupture of membranes (PPROM) and underwent cesarean delivery at (Equation is included in full-text article.)weeks' gestation. A vigorous woman infant of 1955 g, with good Apgar score, was delivered. At 1 month, 4 years, and present, 5 years after birth, she has continued to do well without any obvious deficit and both respiration and circulation were well maintained. CONCLUSION: We present one case of CCAM which was cured by open fetal surgery and continued to do well at follow-up of 5 years. The success of treatment provided preliminary experience for further carrying out such interventions in China.
[Mh] Termos MeSH primário: Malformação Adenomatoide Cística Congênita do Pulmão/cirurgia
Terapias Fetais/métodos
[Mh] Termos MeSH secundário: China
Malformação Adenomatoide Cística Congênita do Pulmão/diagnóstico por imagem
Feminino
Seguimentos
Seres Humanos
Resultado do Tratamento
Ultrassonografia Pré-Natal
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170220
[Lr] Data última revisão:
170220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170113
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000005865


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[PMID]:28058487
[Au] Autor:Kitagawa H; Pringle KC
[Ad] Endereço:Pediatric Surgery, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, 216-8511, Japan. h2kita@marianna-u.ac.jp.
[Ti] Título:Fetal surgery: a critical review.
[So] Source:Pediatr Surg Int;33(4):421-433, 2017 Apr.
[Is] ISSN:1437-9813
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Therapeutic fetal surgical procedures are predicated upon the ability to make an accurate fetal diagnosis. The earliest open fetal surgical procedures were introduced in the 1960s to treat Rh isoimmunisation. They were introduced when it became possible to predict impending fetal demise. Open procedures were abandoned when percutaneous approaches proved superior. The introduction of fetal ultrasound allowed the diagnosis of other congenital anomalies, some being amenable to fetal interventions. Open fetal surgical procedures were initially utilised, with significant maternal morbidity. For some anomalies, percutaneous approaches became favoured. In general, all of these procedures involved significant risks to the mother, to save a baby that was likely to die before or shortly after birth without fetal intervention. Fetal repair for myelomeningocele was a "sea change" in approach. The same maternal risks were taken to improve the quality of life of the affected fetus, not save its life. The completion of the "MOMs Trial" has occasioned a "tsunami" of centres in North America applying this approach. Others are attempting percutaneous repairs, with mixed results. This paper reviews the history of fetal surgery, focusing on the themes of the tension between accurate diagnosis and prognosis and open versus "minimally invasive" approaches.
[Mh] Termos MeSH primário: Feto/cirurgia
[Mh] Termos MeSH secundário: Malformação Adenomatoide Cística Congênita do Pulmão/cirurgia
Feminino
Hérnia Diafragmática/cirurgia
Seres Humanos
Meningomielocele/cirurgia
Gravidez
Região Sacrococcígea/cirurgia
Teratoma/cirurgia
Obstrução Ureteral/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170107
[St] Status:MEDLINE
[do] DOI:10.1007/s00383-016-4044-5


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[PMID]:28040831
[Au] Autor:Yamataka A; Koga H; Ochi T; Imashimizu K; Suzuki K; Kuwatsuru R; Lane G; Nishimura K; Inada E; Suzuki K
[Ad] Endereço:Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan. yama@juntendo.ac.jp.
[Ti] Título:Pulmonary lobectomy techniques in infants and children.
[So] Source:Pediatr Surg Int;33(4):483-495, 2017 Apr.
[Is] ISSN:1437-9813
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Thoracoscopic pulmonary lobectomy (TPL) techniques in infants and children are presented practically with concise descriptions and numerous illustrations. TPL is the treatment of choice for congenital pulmonary airway malformation and intralobar pulmonary sequestration, both now commonly diagnosed prenatally. Timing of surgery is somewhat controversial in asymptomatic cases with small isolated lesions. Incomplete fissures and history of chest infections are most problematic. Thorough understanding of anatomic relations preoperatively is vital for successful outcome and thin-slice computed tomography with 3D reconstruction of vessels is valuable. Judicious placement of trocars and switching instruments between trocars improves visualization and safety. Specific techniques for all commonly performed TPL are included.
[Mh] Termos MeSH primário: Pneumonectomia/métodos
Toracoscopia/métodos
[Mh] Termos MeSH secundário: Sequestro Broncopulmonar/cirurgia
Criança
Malformação Adenomatoide Cística Congênita do Pulmão/cirurgia
Seres Humanos
Lactente
Pulmão/diagnóstico por imagem
Posicionamento do Paciente
Cuidados Pós-Operatórios
Grampeamento Cirúrgico/instrumentação
Grampeamento Cirúrgico/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170102
[St] Status:MEDLINE
[do] DOI:10.1007/s00383-016-4052-5


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[PMID]:27889066
[Au] Autor:Adams S; Jobson M; Sangnawakij P; Heetun A; Thaventhiran A; Johal N; Böhning D; Stanton MP
[Ad] Endereço:Department of Paediatric Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, Hampshire, UK.
[Ti] Título:Does thoracoscopy have advantages over open surgery for asymptomatic congenital lung malformations? An analysis of 1626 resections.
[So] Source:J Pediatr Surg;52(2):247-251, 2017 Feb.
[Is] ISSN:1531-5037
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:AIM: The apparent incidence of antenatally diagnosed congenital lung malformations (CLM) is rising (1 in 3000), and the majority undergo elective resection even if asymptomatic. Thoracoscopy has been popularized, but early series report high conversion rates and significant complications. We aimed to perform systematic review/meta-analysis of outcomes of thoracoscopic vs open excision of asymptomatic CLMs. METHODS: A systematic review according to PRISMA guidelines was performed. Data were extracted for all relevant studies (2004-2015) and Rangel quality scores calculated. Analysis was on 'intention to treat' basis for thoracoscopy and asymptomatic lung lesions. Meta-analysis was performed using the addon package METAN of the statistical package STATA14™; p<0.05 was considered significant. RESULTS: 36 studies were eligible, describing 1626 CLM resections (904 thoracoscopic, 722 open). There were no randomized controlled trials. Median quality score was 14/45 (IQR 6.5) 'poor'. 92/904 (10%) thoracoscopic procedures were converted to open. No deaths were reported. Meta-analysis showed that regarding thoracoscopic procedures, the total number of complications was significantly less (OR 0.63, 95% CI 0.43, 0.92; p<0.02, 12 eligible series, 912 patients, 404 thoracoscopic). Length of stay was 1.4days shorter (95%CI 2.40, 0.37;p<0.01). Length of operation was 37 min longer (95% CI 18.96, 54.99; p<0.01). Age, weight, and number of chest tube days were similar. There was heterogeneity (I 30%, p=0.15) and no publication bias seen. CONCLUSIONS: A reduced total complication rate favors thoracoscopic excision over thoracotomy for asymptomatic antenatally diagnosed CLMs. Although operative time was longer, and open conversion may be anticipated in 1/10, the overall length of hospital stay was reduced by more than 1day. LEVEL OF EVIDENCE: 4 (based on lowest level of article analyzed in meta-analysis/systematic review).
[Mh] Termos MeSH primário: Doenças Assintomáticas
Malformação Adenomatoide Cística Congênita do Pulmão/cirurgia
Pneumonectomia/métodos
Toracoscopia
Toracotomia
[Mh] Termos MeSH secundário: Malformação Adenomatoide Cística Congênita do Pulmão/diagnóstico
Procedimentos Cirúrgicos Eletivos/métodos
Feminino
Seres Humanos
Recém-Nascido
Complicações Pós-Operatórias/epidemiologia
Complicações Pós-Operatórias/etiologia
Gravidez
Diagnóstico Pré-Natal
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170215
[Lr] Data última revisão:
170215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161128
[St] Status:MEDLINE



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