Uniportal video-assisted thoracoscopic right upper sleeve lobectomy and tracheoplasty in a 10-year-old patient.

Abstract

Tracheobronchial pediatric tumors are very rare and procedures like pneumonectomy are seldomly indicated due to the associated morbidity. If a surgical approach is considered, the ideal oncological technique would be the minimally invasive sleeve resection, allowing preservation of lung parenchyma (very important in pediatric patients). Here we present the first report of a thoracoscopic right upper tracheo-bronchial sleeve lobectomy in a pediatric patient. A 10-year-old female patient, who received multiple antibiotic treatments for recurrent pneumonia without improvement, was diagnosed with a right upper lobe (RUL) carcinoid tumor. The patient was proposed for uniportal thoracoscopic surgery. The patient was placed in a lateral decubitus position and a single 3 cm incision was performed at the anterior level of 4th intercostal space. A right upper lobectomy with a tracheo-bronchial sleeve resection using the uniportal technique was successfully performed. The postoperative course was uneventful and the patient was discharged home on the 7th postoperative day. The bronchoscopic control showed excellent caliber of the anastomosis with no complications. The uniportal video-assisted thoracoscopic surgery (VATS) approach is an excellent option for endobronchial tumor management in pediatric patients, offering a quick recovery and low morbidity. The performance of a thoracoscopic sleeve anastomosis in young patients is crucial and should only be performed by very experienced thoracoscopic surgeons.