Masahata Kazunori, Uga Naoko, Nomura Motonari, Kamiyama Masafumi, Okuyama Hiroomi
Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
J Surg Case Rep. 2023 May 15;2023(5):rjad247. doi: 10.1093/jscr/rjad247. eCollection 2023 May.
Congenital pulmonary airway malformation (CPAM) is a developmental malformation that affects the lung parenchyma, especially terminal respiratory bronchioles. This paper reports a case of an infant diagnosed with CPAM who underwent stapleless thoracoscopic lobectomy using Hem-o-Lok clips. Computed tomography showed cystic pulmonary lesions in the left lower lobe. Thoracoscopic lobectomy was performed at the age of 1 year and 3 months. During surgery, the hilar vasculature was treated using either Hem-o-Lok clips or a LigaSure vessel sealing system. The lower lobe bronchus was divided using double Hem-o-Lok clips proximally. The surgery was successfully completed. The patient's postoperative course was uneventful, and there were no complications. This technique can be easily performed as a thoracoscopic lobectomy with the potential benefits of safe and effective procedures for bronchus closure and vascular sealing in the small working space of pediatric patients.
先天性肺气道畸形(CPAM)是一种影响肺实质,尤其是终末呼吸性细支气管的发育畸形。本文报告一例诊断为CPAM的婴儿,该婴儿接受了使用Hem-o-Lok夹的无钉胸腔镜肺叶切除术。计算机断层扫描显示左下叶有囊性肺病变。在1岁3个月时进行了胸腔镜肺叶切除术。手术过程中,肺门血管系统使用Hem-o-Lok夹或LigaSure血管闭合系统进行处理。下叶支气管在近端使用双Hem-o-Lok夹进行离断。手术成功完成。患者术后恢复顺利,无并发症。该技术作为胸腔镜肺叶切除术易于实施,在小儿患者狭小的手术空间内具有支气管闭合和血管封闭安全有效的潜在优势。