Anselmo DM, Perez IA, Shaul DB
Thoracoscopic Pneumonectomy for Severe Bronchiectasis in a 9-Year-Old Female. [JOURNAL ARTICLE]
J Laparoendosc Adv Surg Tech A 2008 Aug 12.
Abstract Introduction: Thoracoscopic total pneumonectomy has not been previously described in the pediatric surgical literature. In this paper, we describe a case of pneumonectomy performed through a minimally invasive approach in a 9-year-old female with Down's syndrome and gastroesophageal reflux disease. Case Report: The patient suffered from multiple recurrent aspiration pneumonias, which progressed to bronchiectasis of the entire left lung. As a result, the patient was hypoxemic and required continuous supplemental oxygen. Preoperative perfusion scans showed diminished perfusion of the left lung. Thoracoscopy was performed by using 3-5 mm trocars and one 12-mm trocar. Insufflation pressure was maintained at 5 mm Hg. Dissection was performed at the hilum by using hook electrocautery and the LigaSuretrade mark device (ValleyLab, Boulder, CO). The pulmonary artery, veins, and left mainstem bronchus were sequentially divided by using a 35-mm ENDO GIA vascular stapler (Ethicon Endo-Surgery, Cincinnati, OH). There were no intraoperative complications. Eight months following surgery, her health is improved and she no longer requires supplemental oxygen.
Conclusion: Thoracoscopic pneumonectomy is a safe, technically feasible approach for severe bronchiectasis in children.
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