Pediatric Bronchogenic Cyst Follow-up

Updated: Jan 18, 2017
  • Author: Mary E Cataletto, MD; Chief Editor: Girish D Sharma, MD, FCCP, FAAP  more...
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Follow-up

Further Outpatient Care

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  • Late recurrences may occur in patients who have undergone partial resection. Long-term follow-up is necessary due to possible recurrence.

  • Long term follow-up is recommended due to the potential risk of malignancy.

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Transfer

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  • Maternal transfer: Infants with large prenatally diagnosed bronchogenic cysts should be delivered in a tertiary center with pediatric surgical capabilities. Although they may not require immediate intervention, evaluation and close follow-up are important in the newborn period.

  • Infant transfer: Symptomatic newborns with cystic lesions should be stabilized and expeditiously transferred to a tertiary center with pediatric surgical capabilities for evaluation and treatment.

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Complications

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  • Mass effect

    • Compression of the GI tract can result in dysphagia.

    • Compression of the airway, especially if cyst is just below the carina, can result in life-threatening respiratory distress.

    • Compression of the heart and great vessels can result in dysrhythmias and obstruction of the vena cava.

  • Cyst-related complications: Infection, rupture, bleeding, and compression are common. A risk of malignant degeneration is also noted.

  • Other: Other reported complications include airway-cyst fistula, ulceration, and hemorrhage.

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Prognosis

In general, postoperative outcomes after resection of bronchogenic cysts are excellent. Thoracoscopic resections are minimally invasive and have advantage of a smaller incision, less post operative pain and better cosmesis.

Poor outcomes have been reported in patients with life-threatening complications preoperatively.

Limaiem et al reported the following perioperative and postoperative complications (no postoperative deaths were reported) [5] :

  • Perioperative rupture of the cyst

  • Postoperative pneumothorax

  • Hemorrhage

  • Pleural effusion

  • Seizure

No long-term complications have been reported with complete resection. [7]

Late recurrences have been reported with partial excisions.

Left untreated, the most common complications include tracheobronchial compression and pulmonary infection.

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Patient Education

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  • Complete surgical excision is recommended as the treatment of choice.

  • Fatal complications of air embolism in an airline passenger and a fatal myocardial infarction secondary to compression of the left main coronary artery have been reported.

  • The more common complications of untreated bronchogenic cysts include pulmonary infection and symptoms of tracheobronchial compression.

  • Long term follow-up is recommended.

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