A Note on Prenatal Ultrasound Diagnosed Lung Abnormalities
Lung lesions are now commonly diagnosed on prenatal ultrasound. As prenatal ultrasound improved the diagnosis of lung lesions in the late 1990s, an effort was made to improve outcomes through fetal treatment centers. Only a few diseases (notably meningomyelocele and twin-twin transfusion) however, showed improved outcomes. Through a high quality trial, we now know that fetal intervention for lung lesions do not improve outcomes. Even for severe cases, such as those with ‘fetal hydrops,” results are better with maternal steroids than with fetal surgery. Our focus and efforts are directed toward minimally invasive newborn lung surgery in 2007.
In 2007, Dr. Kathy Graziano performed the first thoracoscopic formal lung lobectomy at Phoenix Children’s Hospital. While partial lung resections have been done for more than a decade, complete removal of the lobe (as required for some congenital lung lesions) had been considered too technically difficult. Newer devices to seal blood vessels allowed the new techniques to be developed. While these lesions do require much more skill than the open surgery, early adoption and over 5 years of experience has made this available for almost all prenatally diagnosed lung lesions such as CPAMs (Congenital pulmonary airway malformations) (also knows as CCAMs (Congenital cystic adenomatous malformations)), pulmonary sequestration (those with blood vessels coming from the aorta), as well as other miscellaneous lesions.
The surgeons at Pediatric Surgeons of Phoenix now prefer to remove these lesions thoracoscopically and any of our board certified surgeons are available to offer you and your baby the option of a minimally invasive removal.