Shimizu Seiichi, Yamashita Yoshinori, Mukaida Hidenori, Hirabayashi Naoki, Egawa Hiromi, Kaneko Mayumi, Sakatani Akio, Takiyama Wataru
Department of Surgery, Hiroshima City Asa Hospital, Hiroshima, Japan.
Asian J Endosc Surg. 2013 Feb;6(1):44-7. doi: 10.1111/j.1758-5910.2012.00160.x.
Congenital cystic adenomatoid malformation (CCAM) in adolescents or adults is extremely rare. In this case study, a 17-year-old boy was admitted to our clinic for the treatment of a giant bulla in the lower lobe of the right lung. Preoperative imaging studies led to the diagnosis of cystic lung disease. The patient underwent wedge resection of the right lower lobe with VATS, and histological examination confirmed the presentation of type 1 CCAM. A thoracoscopic lobectomy was performed after the second surgery because of postoperative air leakage.Herein, we report a case of CCAM in an adolescent. VATS was a suitable procedure for the operation. Between the parenchyma-saving resection and lobectomy for CCAM, we believe that the lobectomy is the better treatment option when the extent of the disease cannot be determined clearly or it is extremely large. Therefore, strategies for deciding between parenchyma-saving resection and lobectomy for the treatment of CCAM should be developed.
青少年或成人先天性囊性腺瘤样畸形(CCAM)极为罕见。在本病例研究中,一名17岁男孩因右肺下叶巨大肺大疱入住我院接受治疗。术前影像学检查诊断为囊性肺病。患者接受了电视辅助胸腔镜手术(VATS)下的右下叶楔形切除术,组织学检查证实为1型CCAM。由于术后漏气,第二次手术后进行了胸腔镜肺叶切除术。在此,我们报告一例青少年CCAM病例。VATS是适合该手术的术式。在CCAM的肺实质保留切除术和肺叶切除术之间,我们认为当疾病范围无法明确确定或病变极大时,肺叶切除术是更好的治疗选择。因此,应制定CCAM治疗中肺实质保留切除术和肺叶切除术之间的决策策略。