Diagnosis and surgical treatment of pulmonary sequestration in adults / 局解手术学杂志

ABSTRACT

Objective To explore the diagnosis and surgical treatment of pulmonary sequestration in adults. Methods Clinical data of 21 cases of pulmonary sequestration whose diagnosis was confirmed by surgical biopsy in our department from March 2009 to February 2016 were retrospectively analyzed. Divided the patients into the thoracotomy group (n=9) and the thoracoscope group (n=12) according to dif-ferent surgical methods, and compared the diagnosis and surgery of the two groups. Results Among the patients, 8 cases were diagnosed as pulmonary sequestration and the remaining 13 cases were misdiagnosed,with the misdiagnosis rate of 61. 9%. Intraoperative exploration dem-onstrated that the abnormal blood vessels were originated from thoracic aorta (n=14,66. 7%),abdominal aorta (n=4,19%),phrenic artery (n=3,14. 3%) and aortic arch (n=1,4. 8%), and there were 20 cases (95. 2%) of intralobar sequestration and 1 case (4. 8%) of ex-tralobar sequestration. Patients underwent thoracotomy and patients underwent video-assisted thoracoscopic surgery were of no significant differences in operative time (P=0. 104),blood loss (P=0. 209),chest tube duration (P=0. 511),drainage volume (P=0. 135) and postoperative hospital stay (P=0. 450). All the patients recovered well after surgery. Conclusion As pulmonary sequestration lacks specific clinical manifestations,missed diagnosis and misdiagnosis are very common in patients. Chest enhanced CT and CT angiography are effective diagnostic methods at present. Both thoracotomy and VATS can achieve good therapeutic effects.