2016 Volume 52 Issue 5 Pages 1025-1030
Purpose: Congenital cystic adenomatous malformation (CCAM) sometimes requires surgery because of respiratory failure in neonates. In this study, we aimed to evaluate such cases retrospectively, and we devised a method for the management and treatment of CCAM after birth.
Methods: We examined 6 cases of CCAM in neonates that required surgery for respiratory failure. We analyzed them in terms of the clinical course and surgery.
Results: Five boys and one girl were diagnosed as having CCAM antenatally. According to the Stocker classification, 3 had type I, 2 had type II, and 1 had type III, and the locations were the left upper lobe in 1, the left lower lobe in 3, and the right lower lobe in 2. Immediately after birth, all the patients showed respiratory symptoms, and X-ray examination showed the displacement of the mediastinum. Respiratory failure worsened rapidly in four patients. One patient had surgery because of the exacerbation of respiratory distress after intubation. Three patients underwent surgery within 5 h after birth because of severe respiratory distress. These three had type I CCAM. Open lobectomy was carried out in all cases. The mean operative time was 145 min, and the postoperative average hospital stay was 30 days. Postoperative complications were pleural effusion, pneumothorax, and pneumomediastinum in one patient each. Furthermore, in two patients, their CCAM was complicated by PPHN.
Conclusions: CCAM sometimes leads to acute respiratory failure after birth. Therefore, we always consider planning the birth and always having an operable system. Also, ventilator management of CCAM patients involves the risk of respiratory failure. In such cases, surgical treatment is recommended.
