Department of Cardiac Anesthesiology, Clinic for Anesthesiology, Reanimation and Intensive Care, University Clinical Center of Sarajevo,
Sarajevo, Bosnia and Herzegovina
Aim The aim was to show rare cases of congenital cystic adenomatoid malformation (CCAM) and the manner of its surgical treatment with video-assisted thoracoscopic surgery (VATS). Methods Two male and one female child, 7, 4 and 3 years of age were treated for symptoms of cough and high temperature in district hospitals. In all three children laboratory blood tests and chest radiography were done. Auscultatory findings showed the presence of pneumonia. Children were treated with appropriate doses of antibiotics. After the rehabilitation of inflammation, they were sent to the University Clinical Center Sarajevo, where video-assisted thoracoscopic lobectomy (VATS) was indicated after computerized tomography (CT). Results Chest CT scan pointed to the CCAM and pulmonary sequestration (PS) changes to the lungs. This has required surgery lobectomy of an affected part of the lungs. In two children with PS, the aberrant systemic artery came from the most proximal part of aorta abdominals, the third patient did not have an anomalous artery. Conclusion VATS lobectomy is an alternative to the traditional thoracotomy for the treatment of CCAM and PS, however, it should be investigated in the future for its safety and effectiveness.
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Video-asistirana torakoskopska lobektomija kod kongenitalne cistične adenomatoidne malformacije.
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Amina Selimović.
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Odjel dječije hirurgije, 7 Odjel grudne hirurgije; Univerzitetski klinički centar Sarajevo, Sarajevo, Bosna i Hercegovina SAŽETAK Cilj Prikazati rijetki slučaj urođenih malformacija disajnih puteva (CCAM) i način njihovog hirurškog liječenja s video.
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Metode Dva muška djeteta i jedno žensko dijete, u dobi od 7, 4 i 3 godine, liječeni su zbog simptoma kašlja i povišene temperature u regionalnoj bolnici. Kod sve troje djece urađena su laboratorijska ispitivanja krvi i radiografija grudnog koša. Auskultatorni nalazi su pokazali prisutnost upale pluća. Djeca su liječena odgovarajućim dozama antibiotika. Nakon izliječenja upale, transportovani su do Kliničkog centra Univerziteta u Sarajevu, gdje je nakon kompjuterizirane tomografije (CT) urađena video-asistirana torakoskopska lobektomija (VATS).
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Rezultati CT grudnog koša je pokazao CCAM i plućnu sekvestraciju (PS), te je bila potrebna lobektomija da se odstrani dio zahvaćenog plućnog tkiva. Kod dvoje djece s PS-om aberantna krvna žila poticala je od proksimalnog dijela trbušne aorte, dok treće dijete nije imalo PS.
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Zaključak VATS lobektomija je alternativna metoda za tradicionalnu lobektomiju za liječenje CCAM-a i PS-a, ali će njena sigurnost i učinkovitost u budućnosti biti predmet istraživanja. Ključne riječi: plućne malformacije, torakoskopska hirurgija, plućna sekvestracija.
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