Video-Assisted Thoracoscopic Surgery for Pulmonary Sequestrations: Series of 35 Consecutive Patients in a Single Center

Abstract

Objective The aim of this report is to summarize the experience of completely video-assisted thoracoscopic surgery (VATS) for pulmonary sequestration in a single center and to evaluate the long-term outcome in a larger series of patients.

Methods The data of 35 pulmonary sequestrations who received completely VATS consecutively in Peking University People's Hospital between January 2008 and November 2017 were retrospectively reviewed. Twenty-three females and twelve males with an average of 38 years old were included.

Results A total of 28 (80%) patients had preoperative symptoms; leading symptoms were recurrent infections (22), fever (11), hemoptysis (11), chest pain (9), and shortness of breath (4). Twenty-nine (82.9%) patients were intralobar pulmonary sequestration (22 in the left lower lobe, 6 in the right lower lobe, and 1 in the left upper lobe) and six (17.1%) patients were extralobar pulmonary sequestration. All the patients underwent VATS excision successfully, 26 underwent lobectomy, 2 underwent wedge resection, 1 underwent occlusion of the aberrant artery, and 6 underwent mass resection in all of those with extralobar pulmonary sequestration. The median surgery time and estimated blood loss was 150 (75–300) minutes and 50 (10–600) mL, respectively. There was no mortality. Only one patient suffered postoperative complication (recurrent laryngeal nerve injury). During the median follow-up period of 57 months, none of the patients presented recurrence.

Conclusions Completely VATS was a safe and effective mini-invasive procedure for pulmonary sequestration in an experienced team. Its long-term outcome was remarkable.

Keywords

pulmonary sequestration - VATS - treatment

• References

• 1 Corbett HJ, Humphrey GM. Pulmonary sequestration. Paediatr Respir Rev 2004; 5 (01) 59-68
• 2 Kestenholz PB, Schneiter D, Hillinger S, Lardinois D, Weder W. Thoracoscopic treatment of pulmonary sequestration. Eur J Cardiothorac Surg 2006; 29 (05) 815-818
• 3 Gezer S, Taştepe I, Sirmali M. , et al. Pulmonary sequestration: a single-institutional series composed of 27 cases. J Thorac Cardiovasc Surg 2007; 133 (04) 955-959
• 4 Watine O, Mensier E, Delecluse P, Ribet M. Pulmonary sequestration treated by video-assisted thoracoscopic resection. Eur J Cardiothorac Surg 1994; 8 (03) 155-156
• 5 Wang LM, Cao JL, Hu J. Video-assisted thoracic surgery for pulmonary sequestration: a safe alternative procedure. J Thorac Dis 2016; 8 (01) 31-36
• 6 Lin CH, Chuang CY, Hsia JY. , et al. Pulmonary sequestration-differences in diagnosis and treatment in a single institution. J Chin Med Assoc 2013; 76 (07) 385-389
• 7 Shen JF, Zhang XX, Li SB. , et al. Complete video-assisted thoracoscopic surgery for pulmonary sequestration. J Thorac Dis 2013; 5 (01) 31-35
• 8 Albanese CT, Sydorak RM, Tsao K, Lee H. Thoracoscopic lobectomy for prenatally diagnosed lung lesions. J Pediatr Surg 2003; 38 (04) 553-555
• 9 Klena JW, Danek SJ, Bostwick TK, Romero M, Johnson JA. Video-assisted thoracoscopic resection for intralobar pulmonary sequestration: single modality treatment with video-assisted thoracic surgery. J Thorac Cardiovasc Surg 2003; 126 (03) 857-859
• 10 Liu C, Pu Q, Ma L. , et al. Video-assisted thoracic surgery for pulmonary sequestration compared with posterolateral thoracotomy. J Thorac Cardiovasc Surg 2013; 146 (03) 557-561
• 11 Suda T, Hasegawa S, Negi K, Hattori Y. Video-assisted thoracoscopic surgery for extralobar pulmonary sequestration. J Thorac Cardiovasc Surg 2006; 132 (03) 707-708
• 12 Xuan HY, Shi KH, Gong WH, Wu JX. Extralobar pulmonary sequestration in a 55-year-old man. Ann Thorac Cardiovasc Surg 2014; 20 (Suppl): 564-566
• 13 Takeuchi K, Ono A, Yamada A. , et al. Two adult cases of extralobar pulmonary sequestration: a non-complicated case and a necrotic case with torsion. Pol J Radiol 2014; 79: 145-149