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视频辅助胸腔镜修补术治疗儿童胸壁肿瘤切除术后蛛网膜-胸腔瘘:技术说明。

Video-assisted thorascopic repair of a subarachnoid-pleural fistula in a child after thoracic tumor resection: technical note.

机构信息

Division of Pediatric Neurosurgery, Department of Neurosurgery, Texas Children's Hospital, Houston, TX, USA.

出版信息

Spine (Phila Pa 1976). 2010 Apr 20;35(9):E347-50. doi: 10.1097/BRS.0b013e3181d83538.

Abstract

STUDY DESIGN

Technical report.

OBJECTIVE

To describe a minimally invasive surgical approach for the obliteration of a subarachnoid-pleural fistula in a 4-year-old child after resection of an intrathoracic ganglioneuroma.

SUMMARY OF BACKGROUND DATA

Development of a subarachnoid-pleural fistula has been reported after thoracotomy for lung, chest wall, and spinal tumors, when an iatrogenic meningeal laceration results in establishing communication between the spinal subarachnoid space and the pleural cavity.

METHODS

Review of a single case in which video-assisted thorascopic surgery (VATS) was used to deposit fibrin glue and to suture a pleural allograft. Literature review was performed to document other options to treat subarachnoid-pleural cerebrospinal fluid (CSF) fistula.

RESULTS

At 10 months after VATS repair, the CSF fistula has remained closed.

CONCLUSION

VATS technique should be considered for a safe, efficacious, and durable CSF leak repair and as an alternative to open thoracotomy in the pediatric age group.

摘要

研究设计

技术报告。

目的

描述在胸腔内神经节细胞瘤切除术后,为一名 4 岁儿童治疗蛛网膜-胸腔瘘的微创外科方法。

背景资料概要

在因肺部、胸壁和脊柱肿瘤进行开胸手术后,当医源性脑膜撕裂导致脊髓蛛网膜下腔与胸腔之间建立沟通时,已报告发生蛛网膜-胸腔瘘。

方法

回顾性分析了一例使用电视辅助胸腔镜手术(VATS)放置纤维蛋白胶和缝合胸腔同种异体移植物的病例。同时对治疗蛛网膜-胸腔脑脊液(CSF)瘘的其他方法进行了文献回顾。

结果

VATS 修复后 10 个月,CSF 瘘仍保持关闭。

结论

VATS 技术应被视为一种安全、有效和持久的 CSF 漏修复方法,并且在小儿年龄段可替代开胸手术。

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