Congenital lobar emphysema (CLE), also known as congenital alveolar overdistension, characterized by over distension and air-trapping in the affected lobe is one of the causes of infantile respiratory distress requiring surgical resection of affected lobe. ,It is a rare congenital malformation with a prevalence of 1 in 20,000 to 1 in 30,000.

The standard surgical treatment of C.L.E. is lobectomy.but the long term sequel of the lobectomy s not well study in the literature espiescally if the lunge associated with other pathology like

Lung volume reduction surgery (LVRS) was undertaken to improve respiratory function and clinical symptoms in a patient with severe emphysema. The procedure included a multiple wedge resection of the emphysematous lung, which resulted in improved lung ventilation efficiency. Lung volume reduction surgery is indicated for adult patients with emphysema and offers clinical improvements in exercise tolerance, lung function, and quality of life; however, the effect of LVRS in infants is still unclear.

we present 2 cases of congenital lobber emphysema which require surgery due to presence of respiratory distress in setting of comprising the other lobe and mediastinal shift . during thoracoscopy we observe that the expansion of the other lobe is minimal inspite of high PEEP deliver by anesthaiology.intraoperative decision to take most the emphysematous part of the affected lobe and leave part of it to help in increase the effective lung volume.both cases did well post operative and been followed at 6 and 12 months post surgery.

In conclusion, thoracoscopic LVRS for the treatment of pulmonary emphysema in infants can be carried out safely with a favourable result .Although the indications for throcoscopic LVRS should be considered carefully, it may be an optional management for CLE in infants.

Congenital lobar emphysema (CLE), also known as congenital alveolar overdistension, characterized by over distension and air-trapping in the affected lobe is one of the causes of infantile respiratory distress requiring surgical resection of affected lobe. ,It is a rare congenital malformation with a prevalence of 1 in 20,000 to 1 in 30,000.

The standard surgical treatment of C.L.E. is lobectomy.but the long term sequel of the lobectomy s not well study in the literature espiescally if the lunge associated with other pathology like

Lung volume reduction surgery (LVRS) was undertaken to improve respiratory function and clinical symptoms in a patient with severe emphysema. The procedure included a multiple wedge resection of the emphysematous lung, which resulted in improved lung ventilation efficiency. Lung volume reduction surgery is indicated for adult patients with emphysema and offers clinical improvements in exercise tolerance, lung function, and quality of life; however, the effect of LVRS in infants is still unclear.

we present 2 cases of congenital lobber emphysema which require surgery due to presence of respiratory distress in setting of comprising the other lobe and mediastinal shift . during thoracoscopy we observe that the expansion of the other lobe is minimal inspite of high PEEP deliver by anesthaiology.intraoperative decision to take most the emphysematous part of the affected lobe and leave part of it to help in increase the effective lung volume.both cases did well post operative and been followed at 6 and 12 months post surgery.

In conclusion, thoracoscopic LVRS for the treatment of pulmonary emphysema in infants can be carried out safely with a favourable result .Although the indications for throcoscopic LVRS should be considered carefully, it may be an optional management for CLE in infants.