Menon Revathy, Rathod Kirtikumar J, Rathod Darshana, Kumar Prawin, Yadav Taruna, Sinha Arvind
Department of Paediatric Surgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
J Indian Assoc Pediatr Surg. 2023 Jul-Aug;28(4):332-335. doi: 10.4103/jiaps.jiaps_80_23. Epub 2023 Jul 11.
Thoracoscopic surgery was not previously accepted in the neonatal population due to inappropriate instrumentation and lack of experience. However, our experience in the last few decades has slowly yet steadily established its safety and efficacy. The major advantages that thoracoscopy offers are early recovery and fewer long-term complications. However, we are aware that this comes at the cost of a steep learning curve and the potential challenge of facing certain complications which may compel a conversion to open. There is a paucity of literature regarding intraoperative complications of neonatal thoracoscopy and its management. Conversion to open thoracotomy is appropriate, keeping patient safety in mind, and any decision made to continue management of a complication thoracoscopically is technically demanding. Iatrogenic bronchial injury is one such rare complication of thoracoscopy with a limited mention in literature. We describe below a 25-day-old patient with a bronchogenic cyst who sustained injury to the left bronchus during thoracoscopic cyst excision, which was successfully repaired thoracoscopically.
由于器械不合适以及缺乏经验，胸腔镜手术此前在新生儿群体中未被接受。然而，我们在过去几十年的经验已缓慢但稳步地确立了其安全性和有效性。胸腔镜手术的主要优势在于早期恢复和较少的长期并发症。然而，我们也意识到这是以陡峭的学习曲线以及面临某些可能迫使转为开放手术的并发症的潜在挑战为代价的。关于新生儿胸腔镜手术术中并发症及其处理的文献较少。在牢记患者安全的前提下，转为开胸手术是合适的，而任何决定通过胸腔镜继续处理并发症的操作在技术上都要求很高。医源性支气管损伤就是这样一种罕见的胸腔镜手术并发症，文献中对此提及有限。我们在下文描述了一名25天大的患有支气管囊肿的患者，其在胸腔镜囊肿切除术中左支气管受损，并通过胸腔镜成功修复。
