Abstract
Purpose:
This 5-year-old male was incidentally found to have a left foregut duplication cyst on an abdominal X-ray as he was being evaluated for urinary retention. A magnetic resonance imaging of the chest was obtained and it demonstrated an echogenic cyst in the left paramediastinum consistent with a foregut duplication cyst vs a bronchogenic cyst necessitating surgical excision.
Methods:
A left video-assisted thoracoscopic resection of the cyst was performed. Once the etiology of the cyst was confirmed to be of bronchogenic origin, key portions of the procedure involved circumferential mobilization of the cyst and identification and preservation of the left inferior pulmonary artery and descending thoracic aorta. Protection of the lung parenchyma was undertaken by clipping the tissue from which the cyst originated and leaving a 16F argyle chest tube to monitor for air leak.
Results:
Final pathology demonstrated a 1.7×1.5×0.5 cm bronchogenic cyst. There was no evidence of air leak, and the patient's chest tube was removed and he was discharged home on postoperative day 2.
Conclusions:
Key factors in safe effective thoracoscopic surgery include a thorough knowledge of the relevant anatomy, identification and preservation of neurovascular structures, and flexibility in adapting to a variety of views dependent on camera positioning.
No competing financial interests exist.
Runtime of video: 5 mins 1 sec
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