Right Middle Lobectomy on Metallic Foreign Body Using the Uniportal Video Assisted Thoracoscopic Surgery: A First Experience in the Democratic Republic of Congo

Ataki, H., Musoni, L., Dzota, J., Ilonga, M, Dibwe, G, Liyongo, H, B. S, Rivas Gonzalez, D, Mounir, A, Ntalaja, J,, Nzomvuama, A, Nzalalemba, D
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Abstract

The removal of metallic foreign bodies in the lower airways, a source of recurrent pneumonia, is not currently performed in the Congolese population using video-assisted thoracoscopy surgery (VATS) under unipulmonary ventilation. Multiple failures of rigid and/or flexible bronchoscopy are likely to be a cause of morbidity and mortality. To the best of our knowledge, we report a first experience in DRC, of right middle lobectomy on metallic foreign body by VATS in a 14-year-old girl after two years of accidental inhalation of a metallic key, in the face of two bronchoscopy failures. A partial transverse bronchotomy successfully performed under VATS allowed extraction of the foreign body followed by bronchial reconstruction with resection of the right middle lung lobe. The aim of the multidisciplinary team was to determine whether lobectomy by VATS would result in shorter hospital stays, fewer complications and faster recovery than lobectomy by thoracotomy, to review the key stages of case management using an unusual approach in the region, and to draw a conclusion based on this first experience.
使用单孔视频辅助胸腔镜手术进行金属异物右中叶切除术:刚果民主共和国的首次经验
下呼吸道中的金属异物是复发性肺炎的来源之一,目前在刚果人口中还没有在单肺通气的情况下使用视频辅助胸腔镜手术(VATS)来清除下呼吸道中的金属异物。刚性和/或柔性支气管镜检查的多次失败很可能是导致发病和死亡的原因之一。据我们所知,在刚果(金),我们首次报道了一名 14 岁女孩在意外吸入金属钥匙两年后,在两次支气管镜检查失败的情况下,通过 VATS 对金属异物进行右中叶切除术的经验。在 VATS 下成功进行了部分横支气管切开术,取出异物后进行了支气管重建和右肺中叶切除术。多学科团队的目的是确定与开胸肺叶切除术相比,VATS 肺叶切除术是否能缩短住院时间、减少并发症和加快康复,回顾该地区采用非同寻常的方法进行病例管理的关键阶段,并根据首次经验得出结论。
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