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婴儿患者右上支气管闭锁合并右下叶奇叶的胸腔镜肺叶切除术:罕见病例报告

Thoracoscopic Lobectomy for Right Upper Bronchial Atresia Combined With an Azygos Lobe of the Right Lower Lobe in an Infant Patient: A Case Report of a Rare Condition.

作者信息

Nishida Nanako, Yano Keisuke, Tabata Yumiko, Kedoin Chihiro, Nagano Ayaka, Harumatsu Toshio, Tsuruno Yudai, Murakami Masakazu, Sugita Koshiro, Onishi Shun, Yamada Koji, Yamada Waka, Kawano Takafumi, Ieiri Satoshi

机构信息

Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan.

出版信息

Asian J Endosc Surg. 2025 Jan-Dec;18(1):e70019. doi: 10.1111/ases.70019.

Abstract

Bronchial atresia (BA) and azygos lobe (AL) are rare congenital pulmonary abnormalities in pediatric patients. We herein report an infantile case of BA combined with AL that was treated with thoracoscopic surgery. The patient was an 8-month-old boy who was preoperatively diagnosed with BA of the right upper lobe (RUL) combined with an AL using fetal magnetic resonance imaging and postnatal enhanced computed tomography. Thoracoscopic surgery using indocyanine green (ICG)-guided near-infrared fluorescence (NIRF) was performed for BA of the RUL. In the operative findings, the upper lobe bronchus was not recognized, and the pulmonary vessels of the RUL were confirmed using ICG-guided NIRF. The AL was connected to the right lower lobe (RLL). Partial RLL, including AL resection, was performed after RUL resection to prevent postoperative infections and torsion. The postoperative course was uneventful. Thoracoscopic surgery using ICG-guided NIRF was safely performed in an infant with a rare condition.

摘要

支气管闭锁(BA)和奇叶(AL)是儿科患者中罕见的先天性肺部异常。我们在此报告一例接受胸腔镜手术治疗的婴儿BA合并AL病例。该患者为一名8个月大的男孩,术前通过胎儿磁共振成像和出生后增强计算机断层扫描诊断为右上叶(RUL)BA合并AL。对RUL的BA进行了使用吲哚菁绿(ICG)引导的近红外荧光(NIRF)的胸腔镜手术。手术中未发现上叶支气管,通过ICG引导的NIRF确认了RUL的肺血管。AL与右下叶(RLL)相连。在RUL切除后进行了包括AL切除在内的部分RLL切除,以防止术后感染和扭转。术后病程平稳。在一名患有罕见疾病的婴儿中安全地进行了使用ICG引导的NIRF的胸腔镜手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/40e8/11718429/acf58a5f2884/ASES-18-e70019-g001.jpg

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