Video-assisted Thoracoscopic Surgery in the Treatment of 7 Children With Pulmonary Airway Malformation or Pulmonary Isolation Complicated With Ipsilateral Mediastinal Bronchogenic Cysts
10.3969/j.issn.1009-6604.2025.02.006
- VernacularTitle:胸腔镜手术治疗小儿先天性肺气道畸形或肺隔离症合并同侧纵隔支气管源性囊肿7例
- Author:
Huashan ZHAO
1
;
Yunpeng ZHAI
;
Rui GUO
;
Yuexia BAI
;
Hongxiu XU
;
Sai HUANG
;
Gang SHEN
;
Shisong ZHANG
Author Information
1. 山东大学附属儿童医院 济南市儿童医院胸外肿瘤外科,济南 250022
- Publication Type:Journal Article
- Keywords:
Video-assisted thoracoscopic surgery;
Children;
Congenital pulmonary airway malformation;
Pulmonary isolation;
Bronchogenic cysts
- From:
Chinese Journal of Minimally Invasive Surgery
2025;25(2):92-96
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the feasibility of video-assisted thoracoscopic surgery(VATS)in the treatment of congenital pulmonary airway malformation(CPAM)or pulmonary isolation complicated with ipsilateral mediastinal bronchogenic cyst in children.Methods From July 2019 to July 2024,VATS was carried out to treat CPAM or pulmonary isolation with ipsilateral mediastinal bronchogenic cyst in 7 children.A three-hole thoracoscopic surgery via lateral thoracic approach was performed.The patients were placed in a healthy lateral position.The observation hole was located at the intersection of the subscapular line and the 5th intercostal space,and the operating hole was established according to the surgical requirements in combination with the lumboscopic diamond rule.A 5 mm trocar was used for all three holes.The pressure of CO2 pneumothorax was 4 mm Hg and the flow rate was 2 L/min,which was adjusted at any time according to the intraoperative conditions of the children.The operation was mainly designed for lung operation.The pulmonary operation was conducted firstly,and then the bronchogenic cyst was treated.If necessary,block resection was applied to avoid serious complications of trachea.Results All the operations were performed under thoracoscopy without conversion to open surgery.The operation time was 37-191 min(median,101 min).The intraoperative bleeding volume was 1-15 ml(median,5 ml).One case was not given a closed chest drainage tube placed,and the other 6 cases were placed a closed chest drainage for 1-5 d(median,3d).Postoperative pathology showed 5 cases of CPAM combined with bronchogenic cysts,including 4 cases of type 2(bronchiole type)and 1 case of type 3(bronchiole/alveolar type),and 2 cases of extralobular pulmonary isolation combined with bronchogenic cysts.All the 7 cases were followed up for 6-57 months(median,27 months),and chest CT showed no recurrence of lesions.Conclusions CPAM or pulmonary isolation may be accompanied by bronchogenic cysts.Preoperative imaging examination should correspond to surgical observation,and careful exploration should be conducted to avoid missed diagnosis.VATS is safe and feasible for treating CPAM or pulmonary isolation with ipsilateral mediastinal bronchogenic cysts.
