Lobectomía pulmonar versus necrosectomía pulmonar como tratamiento quirúrgico de neumonía necrotizante en pediatría. Revisión bibliográfica

Abstract

Background: Necrotizing pneumonia (NP) is a complication of pneumonia, and this is characterized by not presenting improvement in its diagnostic to already established treatments, so it is necessary to opt for more aggressive treatments such as surgery; the most common is pulmonary lobectomy and pulmonary necrosectomy. However, there is no standard for its use. Objective: To compare pulmonary lobectomy versus pulmonary necrosectomy as a surgical treatment for necrotizing pneumonia. Methodology: Narrative literature review, in which papers were obtained in Spanish, English, Portuguese, and Chinese databases such as PubMed, Scopus, ScienceDirect, and SciELO. Thirty-one research studies were used for this literature review. Results: Lobectomy and pulmonary necrosectomy are effective techniques for managing NP; however, necrosectomy presents more short-term problems, such as the formation of bronchopleural fistulas, air leakage, and pneumothorax; nevertheless, it offers a shorter hospitalization time. As for long-term complications, it has been seen that pulmonary function is maintained, but there is a possibility that the patient is more prone to acquiring new respiratory infections. Conclusion: Both techniques are practical and show a rapid improvement in the patient; however, the patient's condition before admission to the operating room should be assessed, as this will determine the short-term complications. In the long term, no alterations in pulmonary function have been observed. Nevertheless, further studies should be carried out on the risk of reinfection and future quality of life.