Abstract

Objective: Middle lobe syndrome (MLS) is characterized by persistent or recurrent atelectasis of the right middle lobe and/or lingula. Only 15% of all patients with MLS were children. In this study, we aimed to evaluate the effect of surgical treatment in children with MLS associated with recurrent pneumonia.

children Materials and Methods: Between 2003 and 2007, six with right MLS were performed pulmonary resection.

Results: there were four girls and two boys with a mean age of 12.3 years ranging from 7 to 16 years old. Four patients were girls and two were boys. It is excluded were not done only middle lobe resection or not operated. The most common symptoms were coughing and expectoration and had all patients. The mean pneumonia attacks period was 4.5 years (range, 2 to 10 years). The indications for surgery were bronchiectasy and recurrent middle lobe pneumonia in two patients, and recurrent pneumonia and persistent atelectasy in four patients. Middle lobectomy through right thoracotomy was done in all six patients. Pathological examination confirmed organizing pneumonia in three patients, destroyed lobs in two patients and bronchiectasy in one patient. Only one patient had postoperative complication of pneumothorax. There were no operative and postoperative mortality. Median length of hospital stay was 8.8 days (range: 6-13 days). Mean follow-up time was 1.3 years (range: 6-42 months) and there was no recurrence of pneumonia.

Conclusion: When the patients are diagnosed with middle lobe syndrome associated with bronchiectasy, bronchial stenosis, lung reexpansion defects and persistent/recurrent pneumonia in spite of medical treatment, lobectomy should be performed.