Kakamad Fahmi H, Ali Razhan K, Mohammed Shvan H, Sofi Mohammed Hawar A, Mustafa Mohammed Q, Salih Abdulwahid M, Abdalla Bzhwen Y
Faculty of Medical Sciences, School of Medicine, Department Cardiothoracic and Vascular Surgery, University of Sulaimani, Sulaimani, Kurdistan, Iraq.
Smart Health Tower, Madam Mitterrand Str, Sulaimani, Kurdistan, Iraq.
Ann Med Surg (Lond). 2021 Oct 30;71:102977. doi: 10.1016/j.amsu.2021.102977. eCollection 2021 Nov.
For many years, thoracotomy has been considered as the standard approach for thoracic injuries. The aim of the current paper is to report a successful use of video assisted thoracoscopic surgery (VATS) as the first line approach for the removal of a bullet retained deep in the lung parenchymal tissue.
A 46-year-old male presented with a vague pain in the chest at the site of a penetrating bullet injury 26 years prior. Chest and native chest Computed Tomography scan (CT scan) showed a 22 mm foreign body inside the substance of the left lower lobe in the anterior segment. Decision was made to remove the foreign body using VATS. The surgery was performed through an uni-port. The left lower lobe was explored and the foreign body was found within the anterior segment. It was removed and the defect was sutured using Vicryl 2/0.
Although VATS has been established to be an accurate evaluating technique for direct evaluation of the chest wall, lung parenchyma, mediastinum and diaphragm, along with its effectiveness in successfully treating a variety of conditions, its use in thoracic trauma is still not well defined.
This report supports the use of VATS as an effective and minimally invasive approach in the removal of foreign bodies in lung parenchyma.
多年来，开胸手术一直被视为治疗胸部损伤的标准方法。本文的目的是报告成功应用电视辅助胸腔镜手术（VATS）作为一线方法，取出深深嵌在肺实质组织中的子弹。
一名46岁男性，26年前因穿透性子弹伤，胸部受伤部位出现隐痛。胸部及胸部平扫计算机断层扫描（CT扫描）显示左肺下叶前段实质内有一个22毫米的异物。决定采用VATS取出异物。手术通过单孔进行。探查左肺下叶，在前段发现异物。将其取出，并用2/0薇乔缝线缝合缺损处。
尽管VATS已被确立为直接评估胸壁、肺实质、纵隔和膈肌的准确技术，并且在成功治疗多种病症方面具有有效性，但其在胸部创伤中的应用仍未得到明确界定。
本报告支持将VATS作为一种有效且微创的方法用于取出肺实质内的异物。
