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

Thorac Cardiovasc Surg. 2019 Jan;67(1):73-78. doi: 10.1055/s-0038-1668596. Epub 2018 Aug 30.

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.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Blood Loss, Surgical
  • Bronchopulmonary Sequestration / diagnostic imaging
  • Bronchopulmonary Sequestration / surgery*
  • China
  • Female
  • Humans
  • Male
  • Middle Aged
  • Operative Time
  • Pneumonectomy / adverse effects
  • Pneumonectomy / methods*
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Risk Factors
  • Thoracic Surgery, Video-Assisted* / adverse effects
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Young Adult