J.Jpn. Surg. Soc.. 79(9): 1205-1208, 1978

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Report on the annual meeting

POSTOPERATIVE PULMONARY DEVELOPMENT IN BOCHDALEK HERNIA AND LUNG DISEASE IN INFANTS AND CHILDREN

Since 7 years ago, postoperative pulmonary development has been studied by radioisotope scanning in 11 cases with Bochdalek hernia and 8 cases with lung disease.
External scintillation scanning of intravenously administrated ¹³¹I or ^99mTc labeled macroaggregates of human serum albumin was employed to evaluate the distribution of pulmonary blood flow and inhalation of ^81mKr gas was used for the measurement of regional lung ventilation.
In Bochdalek hernia, regional ventilation of the affected lung recovered to normal range within a month, but distribution of pulmonary blood flow did not develop to normal range until 5 years postoperatively. This gap in recovery time seemed to cause early postoperative high PaCO₂ level in neonatol Bockdalek hernia. Another terdency was that the younger the age at the time of operation, the slower the development of the pulmonary vascular bed.
In infants with lung disease in which segmental resection or lobectomy was performed, development of the residual lung was good and the residual lung seemed to compensate for the resected lung sufficiently, but in the patients over 5 years old, there was no such tendency.
Pneumonectomy in early infancy should be avoided, because it causes not only poor physical development but also mental retardation.

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