ABSTRACT
OBJECTIVE@#To evaluate the safety and efficacy of reverse partial lung resection for treatment of pediatric pulmonary cysts combined with lung abscesses or thoracic abscess.@*METHODS@#We retrospectively analyzed the clinical data of children undergoing reverse partial lung resection for complex pulmonary cysts in our hospital between June, 2020 and June, 2021.During the surgery, the patients lay in a lateral position, and a 3-5 cm intercostal incision was made at the center of the lesion, through which the pleura was incised and the fluid or necrotic tissues were removed.The anesthesiologist was instructed to aspirate the sputum in the trachea to prevent entry of the necrotic tissues in the trachea.The cystic lung tissue was separated till reaching normal lung tissue on the hilar side.The proximal end of the striated tissue in the lesion was first double ligated with No.4 silk thread, the distal end was disconnected, and the proximal end was reinforced with continuous sutures with 4-0 Prolene thread.The compromised lung tissues were separated, and the thoracic cavity was thoroughly flushed followed by pulmonary inflation, air leakage management and incision suture.@*RESULTS@#Sixteen children aged from 3 day to 2 years underwent the surgery, including 3 with simple pulmonary cysts, 11 with pulmonary cysts combined with pulmonary or thoracic abscess, 1 with pulmonary cysts combined with tension pneumothorax and left upper lung bronchial defect, and 1 with pulmonary herpes combined with brain tissue heterotaxy.All the operations were completed smoothly, with a mean operation time of 129 min, an mean hospital stay of 11 days, and a mean drainage removal time of 7 days.All the children recovered well after the operation, and 11 of them had mild air leakage.None of the children had serious complications or residual lesions or experienced recurrence of infection after the operation.@*CONCLUSION@#Reverse partial lung resection is safe and less invasive for treatment of complex pediatric pulmonary cysts complicated by infections.
Subject(s)
Humans , Child , Abscess , Retrospective Studies , Lung/surgery , Cysts/surgery , BronchiABSTRACT
Objective To compare the effect of video-assisted minithoracotomy(VAMT)and video-assisted thoracoscopic surgery(VATS)for spontaneous pneumothorax.Methods 98 patiens with spontaneous pneumothorax allocated to VAMT or VATS were selected.The operation time,blood loss during operation,score of postoperative pain,time of postoperative drainage,postoperative hospital stay,surgery cost,rate of complication and recurrence were compared between the two groups.Results All patients were cured.The operation time,postoperative hospital stay and surgery cost were significantly different between VAMT and VATS groups(all P ＜0.05).The parameters of two groups were similar in score of postoperative pain,time of post-operative drainage,blood loss during operation,rate of complication and recurrence(all P ＞ 0.05).Conclusion VAMT was as effective as VATS,but the operation time,postoperative hospital stay and surgery cost was significantly better than VATS.
ABSTRACT
<p><b>OBJECTIVE</b>To analyze the causes of failure of esophageal stent implantation and explore technical improvement of re-implantation of esophageal stent (RIES).</p><p><b>METHODS</b>According to the conditions of the failed stent implantation, 32 patients who required RIES underwent placement of more appropriate esophageal stents with an improved implantation technique. The patients were followed up for 6 months after the operation to evaluate the effects of RIES.</p><p><b>RESULTS</b>The success rate of the operation was 96.9% in these cases, and the esophageal conditions including stricture and fistula were effectively relieved. During the 6-month follow-up, stent migration occurred in 4 cases (12.5%), and esophageal fistula in the upper edge of the re-implanted stent occurred in 2 cases. No stent loss, bleeding, or stricture was found in these cases.</p><p><b>CONCLUSION</b>The improved technique is effective for stent re-implantation after failed esophageal stent implantation with reduced complications associated with esophageal stenting.</p>