Video Assisted Thoracoscopic lobectomy for congenital pulmonary airway

16/07/2019 08:44

Dr. Nguyen Viet Hoa, PhD – Chief of Pediatric and Neonatal Surgery, Viet Duc University Hospital said that the doctors had performed the video assisted thoracotomy to remove the middle part of lung right for a newborn patient Nguyen Duy A. due to the pathology of congenital pulmonary airway .


Child was diagnosed early from birth. Postpartum the patient was followed up and diagnosed at the pediatric department of Viet Duc University Hospital. Thoracic X-ray, CT, showed cystic lung glands occupying the entire lobes between the right lung, pushing the heart and windpipe to the opposite side. Child was undergoing emergency surgery because of difficulty breathing, acute respiratory failure with serious pneumothorax complications. After 1 week of surgery, the child does not have difficulty breathing and has regular breast-feeding.

Normal X-ray: Congenital Lung Cyst displaced the tracheal and heart to the opposite site

CT scan middle follicular lung lobe


A big cyst located in middle part of lung                               The child after 1 week surgery 


Congenital pulmonary airway malformations (formerly known as congenital lung follicular malformations) are rare malformations of the lower respiratory tract, occurring from the fetal stage and quite rare in young children. A part of the fetal lung develops abnormally, including many large and small cysts like grape bunches, they do not have respiratory function like normal lungs and are susceptible to recurrent infections.


Disease manifestations are quite diverse, can cause respiratory failure very early in the neonatal period such as wheezing, convulsive breathing, cyanosis … or manifest disease at a later age similar to other respiratory diseases, recurrent pneumonia many times or with signs such as acute respiratory failure, acute infection.


The disease can be detected early in the fetus by prenatal diagnostic ultrasound. However, after giving birth, it is necessary to make other diagnostic methods such as thoracic X-ray, CT, MRI to determine the exact position, size and degree of influence on the heart and pulse in the chest…


Surgical removal of follicular lung lobe is the standard treatment for this disease. Surgical procedures performed should be depending on size, location and number of lesions. Video Assisted Thoracoscopic surgery has the advantage of less pain, faster recovery, shorter hospitalization, however it requires conditions for resuscitation to ensure good ventilation and the experience of surgeon because of difficulty during operation as narrow operative view.


Dr. Nguyen Viet Hoa, PhD recommends: In cases of prenatal diagnosis, after birth, the children need to be diagnosed. For cases of prenatal diagnosis without repeated re-pneumonia or signs of respiratory failure, acute infection should be diagnosed to eliminate the congenital airway malformation. Children should be taken to a hospital with specialized pediatric surgery department, adequate equipment and conditions for diagnosis, anesthesia and surgery to avoid unwanted complications causing acute respiratory failure which might lead to death..


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