Department of Pediatric Surgery, Hiroshima University Hospital, Kasumi 1-2-3 Minami-Ku, Hiroshima, 734-8551, Japan.
Department of Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
J Cardiothorac Surg. 2024 Sep 3;19(1):511. doi: 10.1186/s13019-024-03022-0.
Video-assisted thoracic surgery (VATS) is widely used for thoracic lesions in pediatric patients. VATS is also applied to pediatric mediastinal tumors if there is no adhesion or invasion between the tumor and adjacent neuronal and cardiovascular structures. Here, we present a pediatric case of mediastinal teratoma in which the tumor adhered to the superior vena cava, and resection was safely completed using assisted VATS, an integrated surgical approach comprising mini-thoracotomy with video assistance.
A 9 year-old girl presented with right shoulder pain. Chest radiography and computed tomography revealed a 5.4 × 5.1 × 5.8 cm mass in the right upper anterior mediastinum. She was presumed with a mature teratoma, and resection was performed by assisted VATS with muscle sparing axillar skin crease incision (MSASCI) for a mini-thoracotomy. The procedure was safely completed, with the patient discharged on postoperative day 5. At 1 year postoperatively, there was no recurrence with excellent motor and cosmetic results.
The combination of MSASCI and VATS would be useful not only for mediastinal teratomas but also for other mediastinal tumors and almost all other thoracic lesions in pediatric patients.
视频辅助胸腔镜手术（VATS）广泛应用于小儿胸壁病变。如果肿瘤与邻近的神经和心血管结构之间没有粘连或侵犯，VATS 也适用于小儿纵隔肿瘤。在这里，我们报告了一例纵隔畸胎瘤患儿的病例，肿瘤与上腔静脉粘连，通过辅助 VATS （一种包括视频辅助小开胸术的综合手术方法）安全地完成了肿瘤的切除。
一名 9 岁女孩因右肩部疼痛就诊。胸部 X 线和 CT 显示右上纵隔有一个 5.4×5.1×5.8cm 的肿块。考虑为成熟性畸胎瘤，采用辅助 VATS （通过肌保留腋窝皮褶切口进行小开胸术）进行肿瘤切除。手术过程安全完成，患者术后第 5 天出院。术后 1 年，无复发，运动和美容效果良好。
MSASCI 和 VATS 的联合应用不仅对纵隔畸胎瘤，而且对其他纵隔肿瘤和几乎所有其他小儿胸壁病变都非常有用。
