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Needlescopic Video-assisted Thoracic Surgery for Paraesophageal Bronchogenic Cyst

迷你胸腔鏡手術應用於食道旁支氣管源性囊腫的切除

摘要


縱膈腔支氣管源性囊腫並不常見於成人,因此以胸腔鏡來處理這類囊腫的經驗可以說是相當難得;隨著微創手術的概念以及內視鏡手術技術與器械的進步,迷你胸腔鏡手術開始被應用於各種胸腔手術之中。 我們在此分享一個成功應用迷你胸腔鏡手術完整移除和食道壁緊黏的支氣管源性囊腫之經驗。這個二十六歲沒有任何系統性疾病的男性,在一次例行性健康檢查之中意外發現食道旁支氣管源性囊腫的存在,經過胸部電腦斷層以及內視鏡超音波的評估之後,我們決定以迷你胸腔鏡手術為病人切除病灶;術後第二天病人在食道攝影確認無滲漏後順利移除胸管,並於術後第四天出院。 這個經驗告訴我們,在謹慎的術前評估之後,即使迷你胸腔鏡的視野較小,其應用於縱膈腔腫瘤的切除,相較於傳統胸腔鏡手術,在安全上並無二致;而迷你胸腔鏡手術因傷口更小,可以減輕病人術後的疼痛感,縮短病人的胸管引流時間以及住院天數,並增加病患對傷口美觀的滿意度。

並列摘要


The authors report an adult with a paraesophageal bronchogenic cyst which was encountered incidentally during a routine chest roentgenogram in a health examination. Needlescopic video-assisted thoracic surgery was successfully utilized to remove the bronchogenic cyst that was densely adherent to the adjacent esophagus. After operation, the patient had an uneventful recovery and a normal esophagogram, and was discharged on postoperative day 4. Our present case suggests that needlescopic video-assisted thoracic surgery provides a more minimally invasive technique with the same safety profile as conventional thoracoscopic surgery in managing mediastinal masses.

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