Mini-invasive technologies in the treatment of a bronchogenic cyst in a 7-month old child

Abstract

Introduction. Bronchogenic cysts is a rare congenital malformation of the tracheal tree that develops because of violated differentiation of the foregut on week 5–8 of embryogenesis. This disease is often complicated with respiratory failure due to trachea compression; heart failure may develop as well due to of heart and large main vessels compression. One of the most serious complications is erosion of the vessel wall and massive bleeding from main vessels.

Clinical observation. A 7-month-old child with cough and stridor was admitted to the surgical thoracic department of National Medical Research Center for Children’s Health in Moscow. Examination revealed a bronchogenic cyst which caused compression stenosis of the trachea. The patient successfully survived thoracoscopy. This technology promoted adequate visualization of the formation and of the adjacent anatomical structures what allowed to isolate the formation in a precise manner. So, the cyst was completely removed without any pathological immature tissue left. In this particular case, there was a high risk of perforation of the trachea posterior wall at surgery and at early postoperative period. Such complication could require intraoperative conversion with circular resection of the trachea using high-frequency jet ventilation with Twin Stream apparatus, or the patient had to be transferred to extracorporeal membrane oxygenation so as to provide an adequate surgical intervention.

Conclusion. In a multidisciplinary medical center, there has been performed a successful surgical treatment of a 7-month-old child with a large bronchogenic cyst that compressed the trachea using minimally invasive modern technologies.

Keywords

bronchogenic cyst / tracheal stenosis / compression stenosis of the trachea / thoracoscopy / pediatric surgery / mini-invasive technologies

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