关键词: Bronchogenic cyst mediastinal cyst mediastinum robotic surgery

来  源:   DOI:10.21037/med-22-46   PDF(Pubmed)

Abstract:
UNASSIGNED: Bronchogenic cysts represent a rare form of cystic malformation of the respiratory tract. Primarily located in the mediastinum if occurring early in gestation as opposed to the thoracic cavity if arising later in development. However, they can arise from any site along the foregut. They exhibit a variety of clinical and radiologic presentations, representing a diagnostic challenge, especially in areas with endemic hydatid disease. Endoscopic drainage has emerged as a diagnostic and potentially therapeutic option but has been complicated by reports of infection. Surgical excision remains the standard of care allowing for symptomatic resolution and definitive diagnosis via pathologic examination; minimally invasive approaches such as robotic and thoracoscopic approaches aiding treatment. Following complete resection, prognosis is excellent with essentially no recurrence.
UNASSIGNED: A review of the available electronic literature was performed from 1975 through 2022, using PubMed and Google Scholar, with an emphasis on more recent series. We included all retrospective series and case reports. A single author identified the studies, and all authors reviewed the selection until there was a consensus on which studies to include.
UNASSIGNED: The literature consisted of relatively small series, mixed between adult and pediatric patients, and the consensus remains that all symptomatic lesions should be excised via minimally invasive approach where feasible.
UNASSIGNED: Surgical excision of symptomatic bronchogenic cysts remains the gold standard, with endoscopic drainage being reserved for diagnosis or as a temporizing measure in clinically unstable patients.
摘要:
支气管囊肿是一种罕见的呼吸道囊性畸形。如果发生在妊娠早期,主要位于纵隔,如果发生在发育后期,则位于胸腔。然而,它们可以来自前肠的任何部位。他们表现出各种临床和放射学表现,代表诊断挑战,特别是在有包虫病流行的地区。内窥镜引流已成为一种诊断和潜在的治疗选择,但由于感染的报道而变得复杂。手术切除仍然是护理标准,可以通过病理检查解决症状和明确诊断;微创方法,例如机器人和胸腔镜方法,有助于治疗。完全切除后,预后良好,基本无复发。
从1975年到2022年,使用PubMed和GoogleScholar对可用的电子文献进行了审查,强调最近的系列。我们纳入了所有回顾性系列和病例报告。一位作者确定了这些研究,所有作者都对选择进行了审查,直到就纳入哪些研究达成共识。
文献由相对较小的系列组成,混合在成人和儿童患者之间,共识仍然是,所有有症状的病变都应在可行的情况下通过微创方法切除。
手术切除有症状的支气管囊肿仍然是金标准,保留内窥镜引流用于诊断或作为临床不稳定患者的临时措施。
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