Shibuya Soichi, Nakamura Toru, Miyazaki Eiji
Department of Pediatric General and Urogenital Surgery, Juntendo University, Tokyo, Japan.
Department of Pediatric Surgery, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan.
European J Pediatr Surg Rep. 2017 Jan;5(1):e21-e25. doi: 10.1055/s-0037-1603592. Epub 2017 Jul 4.
Anatomical segmentectomy is an advantageous procedure because it spares healthy lung that has potential to show compensatory growth after lung resection and decreases the risk of air leak and residual resection, which becomes a problem in wedge resection. However, anatomical segmentectomy has not become a common procedure in pediatrics because it requires more complicated procedure than lobectomy or wedge resection, especially in patients with a history of pulmonary infection. In this case report, anatomical basal segmentectomy was safely performed with magnified vision by a hybrid video-assisted thoracic surgery (VATS) approach in a 6-year-old girl with intralobar pulmonary sequestration after severe pneumonia. The result suggests that the indications for hybrid VATS segmentectomy can expand further to include segmental lesions in children.
解剖性肺段切除术是一种具有优势的手术方式，因为它能保留在肺切除后有代偿性生长潜力的健康肺组织，并降低漏气和残留切除的风险，而这在楔形切除术中是个问题。然而，解剖性肺段切除术在儿科尚未成为常规手术，因为它比肺叶切除术或楔形切除术需要更复杂的操作，尤其是对于有肺部感染史的患者。在本病例报告中，一名6岁患有叶内型肺隔离症且曾患严重肺炎的女孩，通过混合电视辅助胸腔镜手术（VATS）方法在放大视野下安全地实施了解剖性肺基底段切除术。结果表明，混合VATS肺段切除术的适应证可以进一步扩大，以包括儿童的节段性病变。
