Lung Cysts in infants and children, Congenital cystic adenomatoid malfation (ccam)
Dear parents,
Cysts or cysts have been detected in your baby’s lungs during the detailed ultrasonography performed on you during your pregnancy, and the pressure they create may have put the healthy lung and heart under pressure. This whole picture may naturally cause you some anxiety. Please don’t panic.
- In the vast majority of these cases, there will be no life-threatening danger to your baby or mother, and your baby will most likely be born without problems.
- It is necessary if a condition called hydrops is detected in the ultrasonography performed to terminate the pregnancy or if other important diseases occur in the baby.
- The pregnancy does not need to be terminated just because of the presence of a cyst in the lung or the pressure of the cyst on the heart.
The most common cysts detected in the lung of the baby in the womb are Congenital (Congenital) Cystic Adenomatoid Malformation (abbreviated as CCAM), Pulmonary Sequestration and Congenital (Congenital) Lobar Emphysema.
Congenital Cystic Adenomatoid Malformations (CCAM)
These cysts are detected while in the womb. They usually occur in the lower parts of the lung. They may be in the form of small multiple cysts or a single large cyst.
How to Follow and Treat Babies with CCAM?
Follow-up and treatment are determined by the size of the cyst, the complaints that occur in the baby, and whether the cyst grows, stays the same, shrinks or disappears in the follow-up films.
- After birth, computed lung (thorax) tomography is performed to determine the initial state of the cyst.
- A new computed tomography is taken 11 months after birth and the cyst is compared
- If there is no regression or growth according to the first tomography, the cystic lung lobe is removed by closed surgery.
- If there is regression or the diameter of the cyst is very small, surgery is not required. However, lung cysts are followed regularly by a physician.
- Large cysts, on the other hand, are removed by closed surgery when the baby is one year old, regardless of whether there is a complaint or symptom.
- If the baby does not have feeding difficulties, frequent illness, growth retardation, bruising and similar complaints, he/she is followed up by the pediatrician for 11 months.
- If the baby does not have the aforementioned complaints, there is no need for surgery until the age of 1
- There is no change in the long-term functions of the baby after the operation.
- The operation eliminates the child’s future respiratory distress and frequent infections.
Closed Method in Lung Cyst Surgery in Baby / Child
Since the open method is more painful, has a longer recovery time and is performed with a large incision, a permanent and quite long incision scar appears in the child after the operation.
Closed surgery method is preferred as much as possible in children and babies.
Closed Lung Surgery is Possible in Babies and Children!
Most of the time, parents tell us that they have been told that ‘closed surgery is not possible in babies’. This is not correct information.
Closed surgery is possible in babies after 7 months of age.
Closed surgery is performed by surgeons with a high number of surgical experience using special devices (VATS)
Lobectomy is performed through a closed incision of only 2cm, rarely 3cm (called thoracoscopy or VATS)
In the closed method, as in the open surgery, the baby’s ribs are not opened. The image is taken with the camera advanced through a single incision of 2 or 3 cm, and the diseased area is removed from the same area using special instruments.
This method requires special experience. It is only applied in advanced centers.
Intensive care after surgery is not mandatory. However, considering the concerns of the parents, the baby can be taken to the intensive care unit. In this case, the mother or father stays with their baby.
The hospital stay is 3 or 4 nights.
The experiences of the mothers of babies who had closed lung surgery can be read on the forum page below.
https://www.kadinlarkulubu.com/forum/threads/anne-karnindaki-bebekte-kist-olmasi.387109/page-12
Congenital Lobar Emphysema
This usually occurs in the upper lobe of the lung and causes significant respiratory distress in the infant. For this reason, it is sometimes necessary to have an emergency surgery immediately after birth.
Pulmonary Sequestration
- When one lobe of the lung has an abnormal vascular structure, it is inoperable.
- Surgery is essential because it causes frequent infections and bleeding.
- If the operation is OK for the baby, 6 months – It should be performed between 1 year old.
- The thoracoscopic (VATS) method should be preferred to the open method in surgery.
- The hospital stay is 3 or 4 days
- The baby is checked after 1 week