Video-assisted thoracic surgery is associated with better short-term outcomes than open thoracotomy in adult patients with intralobar pulmonary sequestration

Objectives: This study was aimed to investigate potential benefits of thoracoscopic surgery for intralobar pulmonary sequestration in adult patients in terms of short-term surgical outcomes when compared with open surgery.

Methods: Data of 110 consecutive adult patients undergoing thoracoscopic surgery or open surgery for intralobar sequestration from January 2000 to December 2015 at our institution were reviewed. A total of 42 video-assisted thoracic surgery cases and 68 open surgery cases were identified. Perioperative outcomes were compared between video-assisted thoracic surgery and open surgery to evaluate efficacy.

Results: Neither group had surgical mortality. Although the overall morbidity was without statistical significance (P = 0.13), pleural effusion that required repeated thoracentesis was less frequent in thoracoscopic surgery (n = 1, 2.4% vs n = 11, 16.2%, P = 0.028). Thoracoscopic surgery was associated with less intraoperative bleeding [193 (standard deviation, SD 238) ml vs 241 (SD 221) ml, P = 0.013] and shorter postoperative stay [5.0 (SD 2.4) days vs 9.5 (SD 3.7) days, P < 0.001] compared with open thoracotomy. No significant difference was found for operation duration (P = 0.51) or chest drainage days (P = 0.11).

Conclusions: Video-assisted thoracic surgery is associated with less intraoperative bleeding and shorter postoperative hospital stay than is open thoracotomy in surgical resection of intralobar pulmonary sequestration in adult patients.