Egemen EROĞLU, Pınar DAYANIKLI, Gülnihal ŞARMAN, Nüvit SARIMURAT

Cerrahi yapılamayan konjenital kistik adenomatoid malformasyonlu olguların takibi

Amaç: Bu çalışmanın amacı kistik adenomatoid malformasyonda konservatif yaklaşımın potansiyel de- ğerine dikkat çekmektir. Gereç ve yöntem: Kliniğimizde cerrahi yapılamadı- ğı için konservatif takip edilen kistik akciğer malformasyonlu üç olgunun dosyaları taranmış ve son durumları öğrenilerek sunulmuştur. Bulgular: Antenatal takiplerinde hidronefroz dı- şında hiçbir özellik olmayan 32., 34. ve 35. gestasyon haftalarında biri kız üç olgu, kanama ve erken membran yırtılması nedenleriyle sezeryan ile doğurtulmuşlardı. Otuz iki haftalık olan bebeğin ilk dakika APGAR değerlendirmesi 0 olup diğerlerinin ki ise 9 idi. Apgarı 0 olan yenidoğan hemen entübe edilerek yoğun bakıma alınmış, diğerleri ise solunum sıkıntısı nedeniyle ilerleyen saatlerde entübe edilmek zorunda kalmışlardı. Takipleri esnasında çekilen grafileri ile konjenital kistik adenomatoid malformasyon düşünülen yenidoğanlara ameliyat endikasyonu konulmuş, ancak hızla klinik olarak iyileşme belirtileri göstermeleri üzerine cerrahinin ertelenmesi kararı alınmıştı. Olgular şu an 6., 5., ve 3.5. takip yıllarında bulunmaktadırlar ve klinik olarak sorunsuz seyretmektedirler. Sonuç: Mevcut çalışmadaki hastalar konservatif takipleriyle klinik olarak sorunsuz seyretmektedirler ancak düzenli bir takip protokolünün oluşması ve hangi modalitelerle ne sıklıkla takip edilmesinin netleşmesi için daha çok hastaya, takip süresine ve veriye ihtiyaç vardır.

Follow up of Congenital Cystic Adenomatoid Malformation Cases that surgery could not be performed

Aim: The aim of this study is to attract attention to the possible importance of conservative treatment in cystic adenomatoid malformation Materials and method: The files of three conservatively followed cystic adenomatoid malformation patients, whom surgery could not be performed, were reviewed and the children were contacted to update their last clinical status. Results: Three babies with normal antenatal follow ups, except one hydronephrosis, were delivered by cesarean section due to early membrane rupture and bleeding at the 32nd, 34th and 35th weeks of gestation. The first APGAR score of the 32 week-old baby was 0, and the other two babies APGAR was 9. The newborn with 0 score was intubated and taken to the NICU directly, and the others later also needed to be intubated due to respiratory stress. After the radiologic studies, the babies were thought to have congenital cystic adenomatoid malformation and were registered for surgical treatment. Due to the rapid clinical and radiological improvement, surgery was postponed. They are now on their 3.5, 5th and 6th years of follow up and they are completely healthy. Conclusions: Patients in the present study are clinically disease free with conservative treatment but for better methodical follow up protocols, more patients and longer follow up periods are needed.

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