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胸腔镜治疗一名3岁女童罕见的双侧肺叶外型肺隔离症

Thoracoscopic treatment of a rare bilateral extralobar lung sequestration in a 3-years old girl.

作者信息

Bleve Cosimo, Conighi Maria Luisa, Biondini Diego, Ceccarelli Pier Luca, Giarraputo Leonardo, Savastano Sergio, Chiarenza Salvatore Fabio

机构信息

Department of Pediatric Surgery and Pediatric Minimally Invasive Surgery and New Technologies, San Bortolo Hospital, Vicenza.

Department of Pediatric Surgery, University of Modena and Reggio Emilia, Policlinico of Modena.

出版信息

Pediatr Med Chir. 2021 Feb 8;42(2). doi: 10.4081/pmc.2020.237.

Abstract

Majority of sequestrations fall into two categories: Intra-Lobar (ILS) and Extra-Lobar (ELS). Rarely the abnormal lung could be attached to the gastrointestinal tract, Bronchopulmonary Foregut Malformation (BPFM). We described a case of a girl of 3-years-old with antenatal diagnosis of left intrathoracic mass of the inferior lobe. Postnatal Computed-Tomography (CT) revealed a bilateral ELS with an isthmic bridge crossing the vertebral spine. She follows a MRI follow-up at 18months/30months confirming the lesion. Before surgery, a three-dimensional-CT-angiography was performed to study the mass, its blood supply and to plan surgery. She underwent to thoracoscopic resection. Two aberrant blood vessels were dissected from the thoracic aorta and ligated. The postoperative course was uneventful. She was discharged after 3 days. The rarity of our case is due to the bilateral extension. An appropriate preoperatory imaging study is necessary for the success of surgery while thoracoscopy is particularly appropriate in surgical treatment.

摘要

大多数肺隔离症分为两类

叶内型(ILS)和叶外型(ELS)。极少数情况下,异常肺可与胃肠道相连,即支气管肺前肠畸形(BPFM)。我们描述了一例3岁女孩,产前诊断为左下叶胸腔内肿块。出生后计算机断层扫描(CT)显示双侧叶外型肺隔离症,有一个峡部桥跨越脊柱。她在18个月/30个月时进行了MRI随访,证实了病变。手术前,进行了三维CT血管造影以研究肿块、其血供并规划手术。她接受了胸腔镜切除术。从胸主动脉分离并结扎了两根异常血管。术后过程顺利。3天后出院。我们病例的罕见性在于双侧延伸。适当的术前影像学检查对于手术成功至关重要,而胸腔镜在手术治疗中特别适用。

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