Elective Uniportal Video-Assisted Thoracoscopic Lobectomy for Congenital Cystic Lung Disease in a 2-Year-Old Child Using One-Lung Ventilation

Abstract

To the best of our knowledge, no previous reports have described the indication criteria and details of uniportal video-assisted thoracoscopic lobectomy in younger children. We report the utility of uniportal video-assisted thoracoscopic right lower lobectomy via a 2-cm incision in a 2-year-old child with a prenatal diagnosis of congenital cystic lung disease. A male infant with a prenatal diagnosis of congenital cystic lung disease was delivered vaginally at 36 weeks of gestation. Computed tomography after birth showed that the disease was limited to the right lower lobe. The patient was asymptomatic and was initially treated conservatively. At the age of 2 years and 10 months, when compensatory lung growth can still be expected, the patient had become large enough to safely undergo one-lung ventilation and thoracoscopic surgery. Therefore, we decided to perform a curative lobectomy. A single 2-cm incision was made at the anterior axillary line on the 6th intercostal space. The vessels and bronchus were approached from the anterior side. We used a 3-mm thoracoscope and instruments with a small diameter. The patient was discharged without any complications or need for analgesic drugs. The crossing technique was utilized to minimize the interference between multiple instruments in a small incision with a narrow intercostal space.