Atila EROĞLU, Mustafa KARA, Yener AYDIN, Recep SADE, Bayram ALTUNTAŞ, İlker İNCE

Yenidoğan ve bebeklerde göğüs cerrahisi

Amaç: Bu çalışmada kliniğimizde yenidoğan (yaşamın ilk 28 günü) ve bebeklerde (bir yaşına kadar olan dönem) uygulanan majör göğüs cerrahisi girişimlerinin sonuçları değerlendirildi.Çalışma planı: Kliniğimizde Ocak 2000 - Aralık 2014 tarihleri arasında göğüs cerrahisi girişimleri uygulanan ardışık 27 yenidoğan ve bebek (14 erkek, 13 kız) retrospektif olarak incelendi. Hastaların 10’u (%37) yeni doğan (ort. yaş 98.4±103.1 gün; dağılım 2-340 gün) idi. Hastaların yaşı, cinsiyeti, tanısı, cerrahi işlemi, ameliyat sonrası yatış süresi, komplikasyonları ve mortalite oranları gözden geçirildi. Neonatal pnömotoraks nedeni ile tüp torakostomi uygulanan veya herhangi bir nedenden dolayı bronkoskopi uygulanan hastalar çalışmaya dahil edilmedi.Bulgular: Cerrahi endikasyon 10 hastada (%37) doğuştan kistik pulmoner malformasyon (altı lober amfizem, dört kistik adenomatoid malformasyon), dört hastada (%14.8) mediastinal kist (üç gastroenterik kist, bir kistik teratom), dört hastada (%14.8) doğuştan diyafragma hernisi (üç Morgagni hernisi, bir Bochdalek hernisi), üç hastada (%11.2) diyafragma evantrasyonu, iki hastada (%7.4) mediastinal kavernöz hemanjiom ve birer hastada (%3.7) Jeune sendromu, kleft sternum, doğuştan şilotoraks ve göğüs duvarı tümörü (lipoblastom) idi. Ameliyat sonrası iki hastada (%7.4) atelektazi gözlendi. Jeune sendromlu bir hastada (%3.7) hastane mortalitesi gözlendi. Ortalama ameliyat sonrası yatış süresi 6.9 gün (dağılım 1-30 gün) idi.Sonuç: Yenidoğan ve bebeklerde göğüs cerrahisi için endikasyonlar nadir olmasına rağmen, hastaların çoğunda bu girişim hayat kurtarıcı olup başarılı bir şekilde uygulanabilmektedir.

Thoracic surgery in newborns and infants

Background: This study aims to evaluate the results of major thoracic surgical procedures performed in newborns (first 28 days of life) and infants (up to one year of life) in our clinic.Methods: We retrospectively analyzed consecutive 27 newborns and infants (14 males, 13 females) who underwent thoracic surgical procedures between January 2000 and December 2014 in our clinic. Of the patients, 10 (37%) were newborns (mean age 98.4±103.1 days; range 2 to 340 days). We reviewed patients’ age, gender, diagnosis, surgical procedure, postoperative hospitalization time, complications, and mortality rates. Patients who had chest tube for neonatal pneumothorax or bronchoscopy due to any reason were excluded from the study.Results: Surgery indications were congenital cystic pulmonary malformations in 10 patients (37%) (six lobar emphysemas, four cystic adenomatoid malformations) mediastinal cysts in four patients (14.8%) (three gastroenteric cysts, one cystic teratoma), congenital diaphragmatic hernia in four patients (14.8%) (three Morgagni hernias, one Bochdalek hernia), diaphragmatic eventration in three patients (11.2%), mediastinal cavernous hemangioma in two patients (7.4%), Jeune syndrome in one (3.7%), cleft sternum in one, congenital chylothorax in one, and chest wall tumor (lipoblastoma) in one patient. Atelectasis was observed in two patients (7.4%) postoperatively. Hospital mortality was observed in one patient (3.7%) with Jeune syndrome. Mean postoperative hospitalization time was 6.9 days (range 1 to 30 days).Conclusion: Although indications for thoracic surgery are rare in newborns and infants, this intervention may be lifesaving and performed successfully in majority of patients.

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