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电视辅助胸腔镜肺叶切除术治疗叶内型肺隔离症

Video-assisted thoracoscopic lobectomy in the treatment of intralobar pulmonary sequestration.

作者信息

Gonzalez Diego, Garcia Jose, Fieira Eva, Paradela Marina

机构信息

Department of Thoracic Surgery, Coruña University Hospital, Xubias 84, 15006 Coruña, Spain.

出版信息

Interact Cardiovasc Thorac Surg. 2011 Jan;12(1):77-9. doi: 10.1510/icvts.2010.254177. Epub 2010 Oct 23.

Abstract

Pulmonary sequestration is a congenital malformation characterised by cystic, non-functioning embryonic lung tissue with vascularisation of an abnormal systemic artery. They are classified as intralobar (75%) and extralobar (25%) and are more common in the left lung and lower lobes (60-90%). We report two cases of intralobar pulmonary sequestration located in the lower lobe of the left lung which were subjected to video-assisted thoracoscopic surgery (VATS). Both patients had recurrent infections for which, after performing imaging tests, they were diagnosed with intralobar pulmonary sequestration in the left lower lobe, with an afferent arterial branch to the malformation from the aorta. A lower lobectomy was performed by video-assisted surgery, dividing the aberrant aortic artery with an endostapler. A single thoracic chest tube was placed and removed on postoperative day 2 and the patients were discharged on the same day. In both cases, the pathology examination revealed intralobar pulmonary sequestration. Pulmonary sequestrations are uncommon malformations that can be operated on using minimally invasive techniques, thereby permitting early discharge and a low rate of complications.

摘要

肺隔离症是一种先天性畸形,其特征为囊性、无功能的胚胎肺组织,并由异常的体动脉供血。肺隔离症分为叶内型(75%)和叶外型(25%),多见于左肺及下叶(60%-90%)。我们报告两例位于左肺下叶的叶内型肺隔离症患者,均接受了电视辅助胸腔镜手术(VATS)。两名患者均有反复感染,经影像学检查后,诊断为左肺下叶叶内型肺隔离症,畸形由主动脉发出的一条传入动脉分支供血。通过电视辅助手术行下叶切除术,使用腔内吻合器切断异常的主动脉分支。术后放置一根胸腔引流管,术后第2天拔除,患者于同日出院。两例患者的病理检查均显示为叶内型肺隔离症。肺隔离症是一种少见的畸形,可采用微创技术进行手术,从而实现早期出院且并发症发生率低。

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