Giant Pediatric Lymphangioma Resected by Robotic Surgery in the Mediastinum – Case Report
Erlon de Avila Carvalho,
Marina Varela Braga de Oliveira,
Philippe Chaves Winter,
Ana Clara de Paula Caldas,
Astunaldo Júnior de Macedo e Pinho,
Daniel Oliveira Bonomi
Issue:
Volume 9, Issue 1, January 2023
Pages:
1-4
Received:
19 January 2023
Accepted:
10 February 2023
Published:
21 February 2023
Abstract: Lymphangiomas are slow-developing benign malformations of the lymphatic system. They are characterized by lymphatic proliferation in mucous membranes. The diagnosis is based on clinical history and, mainly, imaging findings, such as CT and NMR. Standard treatment demands total surgical excision for curative purposes A 1 year and 4 months old boy went to the hospital’s ER presenting with cough and fever. Chest X-rays showed enlarged mediastinum, and computed tomography (CT) revealed a large cystic lesion in the anterior mediastinum measuring 91x40x68 mm. Propaedeutic was extended with nuclear magnetic resonance (NMR) and transthoracic echocardiogram. A multidisciplinary team formed by pediatricians, pediatric oncologists and thoracic surgeons decided for surgical resection of the mass with the thoracic robotic surgery. Although sternotomy and thoracotomy are classic surgical choices, resection by robotic surgery was preferred in this case. Port placement: the optical portal was positioned at the level of the ninth intercostal space in the posterior axillary line, and the others were positioned under vision, respecting a minimum distance of 7 cm between them. In this case, the trochanters positioning outside of the “remote center” was important, because of the small pleural cavity with less room for tweezers mobility. The dissection and release of tumor adhesions to the brachiocephalic vein, superior vena cava and internal thoracic veins were carried out and the tumor was removed. The patient’s condition improved in the postoperative period, being discharged from the ICU in the first postoperative day and hospital discharge was on the third postoperative day, without any complications. The anatomopathological confirmed mediastinal cavernous lymphangioma.
Abstract: Lymphangiomas are slow-developing benign malformations of the lymphatic system. They are characterized by lymphatic proliferation in mucous membranes. The diagnosis is based on clinical history and, mainly, imaging findings, such as CT and NMR. Standard treatment demands total surgical excision for curative purposes A 1 year and 4 months old boy we...
Show More
Tran Catheter Closure of Ventricular Septal Defects (VSD): Preliminary Results in Children Weighing 5kg or Less
Mirza Mohd Kamran,
Shaad Abqari,
Azam Haseen,
Mayank Yadav
Issue:
Volume 9, Issue 1, January 2023
Pages:
5-8
Received:
9 December 2022
Accepted:
30 December 2022
Published:
22 May 2023
Abstract: Aim: This study aims to evaluate feasibility and complications of device closure of ventricular septal defect (VSD) in children weighing 5kg. Methods: Between March 2018 and March 2021, total 15 patients with Ventricular Septal Defect (VSD) weighing 5Kg or less were taken to Cath lab for percutaneous VSD closure out of which 13 (86%) had successful transcatheter closure and 2 (14%) cases were unsuccessful and subsequently send for surgical closure. All of these13 patients under went transcatheter closure of VSD using either a Amplatzer duct occluder1, Amplatzer duct Occluder 2 or Amplatzer Muscular VSD Occluder. A retrospective review of the results and related complications was done. Results: Among these 15 patients, 7 were females, 6 were male and the mean age was 8.5 (4-16month. The mean weight in this study was 4.46Kg (2.3-5Kg). Mean VSD size was 4.5 (3-10mm), 9 patients had VSD sizes between 3to5mm, 3 had between5-10 mm and 1 with more than 10mm. Among types of VSD, 9 cases were having Perimembranous, 1 was upper muscular, 1was mid while 1was lower muscular and only 1 had outlet muscular VSD. Amplatzer Duct Occluder (ADOI) was used in 2 cases, 9 were closed with Amplatzer Duct Occluder (ADO2) and 2 were selected for closure with Amplatzer Muscular VSD Occluder. Transthoracic Echocardiography (TTE) in immediate post intervention period revealed all these devices in situ with no or minimal residual flow which subsided within 24 hours period. As far as complications are concerned, we had one device embolization noted in our study. Tricuspid regurgitation (TR) was noted at the time of discharge in 4 patients but subsided after 48 hours while trivial aortic regurgitation was noted (AR) only in one case which is under close follow up and not increasing in severity after 6 months follow-up. Conclusions: Transcatheter closure of VSD in children 5kg or less is feasible and safe alternative to surgical VSD closure.
Abstract: Aim: This study aims to evaluate feasibility and complications of device closure of ventricular septal defect (VSD) in children weighing 5kg. Methods: Between March 2018 and March 2021, total 15 patients with Ventricular Septal Defect (VSD) weighing 5Kg or less were taken to Cath lab for percutaneous VSD closure out of which 13 (86%) had successful...
Show More
