The application of thoracoscopic segmentectomy in children and infants with congenital pulmonary diseases
10.3760/cma.j.cn112434-20200514-00261
- VernacularTitle:儿童胸腔镜肺段切除术在先天性肺部疾病中的应用
- Author:
Zheng TAN
1
;
Jiangen YU
;
Jianhua LI
;
Liang LIANG
;
Ting HUANG
;
Yue GAO
Author Information
1. 浙江大学医学院附属儿童医院胸外科 国家儿童健康和疾病临床医学研究中心，杭州 310052
- Keywords:
Lung segmentectomy;
Surgical techniques;
Thoracoscope;
Children and infants
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2021;37(12):741-744
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the efficacy of anatomic thoracoscopic pulmonary segmentectomy in the treatment of congenital pulmonary diseases in children and infants.Methods:There were 38 cases, 21 males and 17 females, aged from 6 months to 10 years old and 2 months, mean(28.1±20.7) months, and weight 6.0-27.5 kg, mean(11.93±4.05) kg who were scheduled to undergo thoracoscopic segmental pneumonectomy from July 2019 to March 2020. Among the 38 cases, there were 27 cases of congenital pulmonary airway malformation and 11 cases of intralobar pulmonary sequestrations, including 1 case of intralobar pulmonary sequestrations with extralobar pulmonary sequestrations and 1 case of intralobar pulmonary sequestrations with bronchial cyst. 3D computed tomography bronchography and angiography(3D-CTBA) was performed before operation to identify the specific lung segment of the lesion. According to the results to plan the operation plan, determine the specific resection of the lung segment.Results:The operation was completed successfully in all groups. The operation time was(72.5±18.2)min, the bleeding volume was(17.3±2.9) ml, chest tube drainage time was(3.1±0.8) days, and the postoperative discharge time was(8.1±2.8) days. Postoperative complications included infection(1 case), atelectasis(1 case), hydropneumothorax(1 case) and pneumothorax(1 case). There was no conversion to thoracotomy and enlarged pulmonary lobectomy. There was no recurrence during the follow-up of 1-9 months.Conclusion:Lung-preserving segmentectomy is technically feasible and safe for congenital pulmonary diseases in children. The 3D-CTBA technique can be used to understand the specific pulmonary segments invaded by the lesions and the relationship between the corresponding pulmonary vessels and bronchi before operation, which is of positive significance for the resection of complex pulmonary segments and good preoperative surgical planning.
