Tainaka Takahisa, Uchida Hiroo, Tanaka Yujiro, Shirota Chiyoe, Yokota Kazuki, Murase Naruhiko, Oshima Kazuo, Shirotsuki Ryo, Chiba Kosuke, Hinoki Akinari
Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Nagoya J Med Sci. 2016 Dec;78(4):447-454. doi: 10.18999/nagjms.78.4.447.
Thoracoscopic lobectomy has recently become a widely used surgical treatment for congenital cystic lung disease, but significant issues can arise in some cases, such as a limited working space in neonates, a limited view in cases involving large cystic lesions. We reviewed the treatment outcomes of neonates that underwent complete thoracoscopic lobectomy or segmentectomy and evaluated the operative difficulties. From January 2008 to October 2015, 38 patients under the age of 1 year underwent complete thoracoscopic lobectomy or segmentectomy for cystic lung disease at our institution. We compared the intra- and postoperative data of the neonate group (N group) with those of the infant group (I group). Fourteen and 24 patients underwent thoracoscopic lobectomy or segmentectomy in the N group and I group, respectively. The operative time and amount of intraoperative blood loss did not differ significantly between the two groups (p=0.694 and p=0.878, respectively), but the duration of the postoperative hospitalization period was significantly longer (p<0.01) in the N group. The frequencies of postoperative complications did not differ significantly between the two groups. The operative time of thoracoscopic lobectomy was significantly longer in cases involving incomplete lobar fissures than in those involving normal lobar fissures. Surgical outcomes of complete thoracoscopic lobectomy for neonatal cases are almost equivalent compared with infantile cases, and thoracoscopic lobectomy takes longer in cases involving incomplete lobar fissures.
电视胸腔镜肺叶切除术最近已成为先天性肺囊性疾病广泛应用的外科治疗方法，但在某些情况下可能会出现重大问题，如新生儿手术操作空间有限、大囊性病变病例视野受限。我们回顾了接受完全电视胸腔镜肺叶切除术或肺段切除术的新生儿的治疗结果，并评估了手术难度。2008年1月至2015年10月，我院38例1岁以下患儿因肺囊性疾病接受了完全电视胸腔镜肺叶切除术或肺段切除术。我们比较了新生儿组（N组）和婴儿组（I组）的术中和术后数据。N组和I组分别有14例和24例接受了电视胸腔镜肺叶切除术或肺段切除术。两组的手术时间和术中失血量无显著差异（分别为p = 0.694和p = 0.878），但N组术后住院时间明显更长（p < 0.01）。两组术后并发症发生率无显著差异。与正常肺叶裂患儿相比，肺叶裂不完全患儿的电视胸腔镜肺叶切除术手术时间明显更长。与婴儿病例相比，新生儿病例完全电视胸腔镜肺叶切除术的手术结果几乎相当，且肺叶裂不完全病例的电视胸腔镜肺叶切除术时间更长。
