小児における診断的胸腔鏡下手術の検討

An Experience with Exploratory Thoracoscopy in Children

　【目的】小児の診断的胸腔鏡下手術をretrospectiveに検討する．【方法】当科で診断的胸腔鏡下手術を施行した7例（10か月〜12歳）を分離換気法，手術術式，術後経過，最終診断の面から検討した．【結果】7例中4例に分離換気上の工夫を要したが，全例で良好な視野が得られた．2例に一過性の酸素飽和度低下を認めた．6例に生検術を行い，1例にはミニ開胸下の根治術を追加した．出血は1例を除き少量で，全例で術中偶発症を認めず，術後在院日数は平均8.4日であった．全例で確定診断が得られ，続く治療方針の決定にきわめて有用であった．【まとめ】診断的胸腔鏡下手術は，小児においても有力な診断法の1つになり得る．

Exploratory thoracoscopic surgery has been widely accepted as useful diagnostic tool in adult populations. However, its feasibility, safety and effectiveness has not been fully assessed in the pediatric populations. We de-scribe our recent experience with successful exploratory thoracoscopic surgery in children.

The study comprised 7 pediatric patients whose mean age was 7 years. Preoperative work-up showed abnor-mal intrathoracic lesions in 3 patients, massive effusion and/or inflammation in 2 patients. and suspicious malig-nancy in 2 patients.