Decortication with uniport video-assisted thoracoscopic surgery for empyema due to postoperative esophageal leakage: a report of two pediatric cases.

IF 0.7 Q4 SURGERY Surgical Case Reports Pub Date : 2024-10-28 DOI:10.1186/s40792-024-02049-8
Yudai Goto, Seiya Ogata, Hirofumi Shimizu, Michitoshi Yamashita, Takuya Inoue, Takeo Hasegawa, Yutaka Shio, Hiroyuki Suzuki, Hideaki Tanaka
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Abstract

Background: Video-assisted thoracoscopic surgery (VATS) is considered useful for the treatment of parapneumonic empyema in children. However, thoracoscopic management of empyema due to esophageal leakage as an operative complication has not been well described in the literature.

Case presentation: We successfully decorticated severe empyema using uniport VATS in 2 children (a 2-year-old boy who suffered esophageal perforation after laparoscopic anti-reflux surgery, and a 7-month-old girl who had anastomotic leakage after thoracoscopic repair of esophageal atresia). In these patients, we noticed that pleural effusion rapidly progressed to empyema and caused respiratory insufficiency due to wide-range coverage by fibrotic pleural rind that was successfully decorticated under video-assisted vision from a mini-thoracotomy, followed by spontaneous healing of the leakage.

Conclusions: We did not attempt to closely approach or try to repair the esophageal leakage. We believe that this is an important tip for these situations.

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用单孔视频辅助胸腔镜手术解除因术后食管渗漏导致的肺水肿:两例儿科病例的报告。
背景:视频辅助胸腔镜手术(VATS视频辅助胸腔镜手术(VATS)被认为是治疗儿童副肺水肿的有效方法。然而,文献中对食管漏引起的气胸并发症的胸腔镜治疗还没有很好的描述:我们使用单孔 VATS 成功地为 2 名儿童(一名 2 岁男孩,腹腔镜抗反流手术后出现食管穿孔;一名 7 个月大的女孩,胸腔镜修复食管闭锁后出现吻合口漏)消除了严重的气胸。在这些患者中,我们注意到胸腔积液迅速发展为肺水肿,造成呼吸困难,原因是纤维化胸膜覆膜范围广,在视频辅助下,我们从迷你胸腔切开术中成功剥离了纤维化胸膜覆膜,随后渗漏自发愈合:结论:我们没有试图靠近或试图修复食管渗漏。结论:我们没有试图靠近或试图修复食管渗漏,我们认为这是此类情况下的一个重要提示。
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审稿时长
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