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同期行电视胸腔镜辅助下单孔肺大疱切除术和微创漏斗胸矫形术。

Bullectomy with video-assisted thoracic surgery and minimally invasive repair of pectus excavatum simultaneously.

机构信息

Department of Thoracic Surgery, Kızıltepe State Hospital, Mardin, Turkey.

Department of Thoracic Surgery, Mardin Training and Research Hospital, Mardin, Turkey.

出版信息

J Cardiothorac Surg. 2024 Nov 6;19(1):625. doi: 10.1186/s13019-024-03003-3.

Abstract

INTRODUCTION

Pectus excavatum (PE) is the most common chest wall deformity. Surgical treatment with minimally invasive repair (MIRPE) is the most preferred surgical procedure. In the presence of additional pulmonary pathologies, simultaneous surgical procedures have been considered, but there are few cases reported in the literature.

CASE PRESENTATION

MIRPE was planned for a 15-year-old male patient due to PE. The day before the surgery, the patient developed sudden onset of shortness of breath. Pneumothorax was observed on the right side in the chest radiograph. Thereupon, the surgery was brought forward. Video-assisted thoracoscopic surgery (VATS) bullectomy was performed in the left lateral decubitus position. MIRPE was then performed through the same incision in the semi-lateral decubitus position. The patient was planned to be discharged on the 7th day, but on the day of discharge, a pneumothorax on the left was observed on the chest x-ray. VATS bullectomy was performed in the left semi-lateral decubitus position. The patient was discharged on postoperative day five.

CONCLUSION

Since the long-term results of simultaneous surgical procedures are unknown. With MIRPE, results such as less pain, shorter hospital stays, and earlier involvement in social life are achieved. Keeping in mind that these advantages may be lost with additional procedures, we think that simultaneous procedures should be planned.

摘要

引言

漏斗胸(PE)是最常见的胸廓畸形。微创修复(MIRPE)是最受欢迎的手术方法。在存在其他肺部疾病的情况下,已经考虑了同时进行手术,但文献中报告的病例很少。

病例介绍

由于 PE,计划对 15 岁男性患者进行 MIRPE。手术前一天,患者突然出现呼吸急促。胸部 X 线片显示右侧气胸。于是,手术提前进行。在左侧侧卧位行电视辅助胸腔镜手术(VATS)肺大疱切除术。然后,通过半侧卧位的相同切口进行 MIRPE。患者计划在第 7 天出院,但在出院当天,胸部 X 线片显示左侧气胸。在左侧半侧卧位行 VATS 肺大疱切除术。患者术后第 5 天出院。

结论

由于同时进行手术的长期结果尚不清楚。采用 MIRPE 可获得疼痛减轻、住院时间缩短和更早参与社会生活等结果。鉴于这些优势可能因附加程序而丧失,我们认为应计划同时进行手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f92/11539814/da73a43021a9/13019_2024_3003_Fig1_HTML.jpg

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