Department of Hepato-Billiary-Pancreatic and Pediatric Surgery, Saitama Medical Center, Saitama Medical University, Kamoda 1981, Kawagoe, Saitama, 3508550, Japan,
Surg Today. 2014 Apr;44(4):761-6. doi: 10.1007/s00595-013-0565-x. Epub 2013 Mar 28.
The indications for and timing of surgical removal of a dislodged thoracoamniotic shunt double-basket catheter are not established, and the side effects of the dislodged into the thoracic cavity remain controversial. The double-basket catheter was designed to reduce the incidence of catheter dislodgement; however, we have encountered four cases of thoracoamniotic shunt double-basket catheter dislodgement into the fetal thorax. The dislodged shunt catheters were removed safely with thoracoscopic assistance within several days of birth, when additional treatments for pleural effusion were needed, such as thoracic drainage tube insertion and adhesion treatment of the thorax. We report the clinical courses of three of these cases of thoracoamniotic shunt tube dislocation. By waiting several days postnatally for stabilization of respiratory and circulatory status and the effective use of thoracoscopic assistance, the dislodged catheter was safely removed from the neonatal thorax. The accumulation of case reports will help establish suitable treatments, and their indication, for a dislodged thoracoamniotic shunt catheter within the fetal thoracic cavity.
尚未确定移位的胸羊水分流双篮导管的手术切除适应证和时机，且导管移位至胸腔的副作用仍存在争议。双篮导管的设计目的是降低导管移位的发生率；然而，我们已经遇到了 4 例胸羊水分流双篮导管移位至胎儿胸腔的情况。在出生后几天内，当需要胸腔引流管插入和胸腔粘连处理等额外的胸腔积液治疗时，通过胸腔镜辅助，安全地取出了移位的分流导管。我们报告了其中 3 例胸羊水分流管脱位的临床过程。通过在出生后等待数天，以稳定呼吸和循环状态，并有效利用胸腔镜辅助，安全地从新生儿胸腔中取出了移位的导管。积累病例报告将有助于确定在胎儿胸腔内发生的移位胸羊水分流导管的合适治疗方法及其适应证。
