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  • Title: [Video-assisted thoracoscopic lobectomy for congenital pulmonary airway malformations (type II congenital pulmonary airway malformations) in a 1-year-old girl].
    Author: Tsunezuka Y, Shimizu Y, Tanaka N.
    Journal: Kyobu Geka; 2009 Mar; 62(3):182-6. PubMed ID: 19280946.
    Abstract:
    Video-assisted thoracic surgery (VATS) is increasingly being used for congenital cystic lung diseases but there are very few reports of VATS lobectomy because of its technical difficulties. Congenital pulmonary airway malformations (CPAM) is a rare congenital developmental abnormality; an immediate and proper surgical resection must be performed for prevention of malignant transformation and recurrent pulmonary infection. Here, we report a case of a 1-year-old girl with type II-CPAM who was successfully treated with VATS lobectomy. Under single lung ventilation, the child was placed in the lateral decubitus position. A skin lateral incision approximately 3 cm long was made and a 5th intercostal thoracotomy from the mid-axillary line was performed. A 5 mm thoracoscope was introduced through the 7th intercostal space at the midaxillary line. Naruke's forceps were used for the ligation of the major vessels and the basal bronchus was closed with continuous sutures. JMS swabs were effective for the stripping of pulmonary vessels sheaths. An ultrasonic cutting and coagulating surgical device was used to incise the incomplete fissure. Histological examination showed type II-CPAM of the right lower lobe accompanied with lung abscess and S10 hypoplasia. For a certain category of patients, surgical lobectomy using the thoracoscopic approach can be a safe and effective treatment for infants with CPAM.
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