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[胸腔镜肺叶切除术治疗气管支气管。1例儿科病例报告]

[Thoracoscopic lobectomy for the treatment of tracheal bronchus. A pediatric case report].

作者信息

García-Hernández Carlos, Carvajal Figueroa Lourdes, Celorio Alcántara Ángel, Landa-Juárez Sergio, Salinas Hernández Edmur

机构信息

Departamento de Cirugía Pediátrica, Hospital Infantil Privado, Ciudad de México, México.

Departamento de Cirugía Pediátrica, Hospital Infantil Privado, Ciudad de México, México.

出版信息

Cir Cir. 2017 Nov-Dec;85(6):557-561. doi: 10.1016/j.circir.2016.10.010. Epub 2016 Dec 24.

Abstract

BACKGROUND

Tracheal bronchus is considered a rare, congenital anomaly, which implies the abnormal origin of a bronchus. When related to repetitive infections the bronchus must be resected, usually via an open procedure.

OBJECTIVE

The aim of this paper is to present the case of a patient with tracheal bronchus of the upper right lobe who presented with repetitive pneumonias. Additionally, this text intends to expose the methodology for its diagnosis and surgical resolution through a thoracoscopic lobectomy.

CLINICAL CASE

One year old female patient who presented with the disorder at two months of age. The patient presented with constant coughing and persistent fever alongside repetitive pneumonias in the upper right lobe. In order to discard the possibility of gastroesophageal reflux, a bronchoscopy and a panendoscopy of the digestive tube were conducted. The aforesaid procedure demonstrated the existence of a tracheal bronchus located in the right lobe, with functional bronchial segmentation. With these findings and due to the presence of repetitive infections, an apical right lobectomy was performed through a thoracoscopy, with favourable results.

CONCLUSIONS

Tracheal bronchus is a rare anomaly that on many occasions is asymptomatic; nonetheless, when related to repetitive infections, a lobectomy must be carried out to avoid further pulmonary damage. This can be done through a thoracoscopy, as was the case with our patient. When treating these patients, it is worth considering they tend to have a different anatomy and to consider the ease at which they can sustain severe inflammation due to repetitive infections.

摘要

背景

气管支气管被认为是一种罕见的先天性异常,意味着支气管起源异常。当与反复感染相关时,通常需通过开放手术切除该支气管。

目的

本文旨在介绍一例右上叶气管支气管患者反复发生肺炎的病例。此外,本文还打算阐述通过胸腔镜肺叶切除术进行诊断和手术解决的方法。

临床病例

一名1岁女性患者,在2个月大时出现该病症。患者伴有持续咳嗽、持续发热以及右上叶反复发生肺炎。为排除胃食管反流的可能性,进行了支气管镜检查和消化道全内镜检查。上述检查证实右叶存在气管支气管,并伴有功能性支气管分段。基于这些发现以及反复感染的情况,通过胸腔镜进行了右上叶尖段切除术,结果良好。

结论

气管支气管是一种罕见的异常,很多时候无症状;然而,当与反复感染相关时,必须进行肺叶切除术以避免进一步的肺部损伤。这可以通过胸腔镜完成,就像我们的患者那样。在治疗这些患者时,值得考虑的是他们往往具有不同的解剖结构,并且要考虑到由于反复感染他们承受严重炎症的难易程度。

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