Pulmonary sequestration in adult patients: a single-center retrospective study

Siying Ren; Lulu Yang; Ying Xiao; Zhongyi Tong; Li Wang; Yan Hu

doi:10.1186/s12931-023-02320-w

Pulmonary sequestration in adult patients: a single-center retrospective study

Respir Res. 2023 Jan 12;24(1):13. doi: 10.1186/s12931-023-02320-w.

Authors

Siying Ren^{1

2

3}, Lulu Yang^{1

2

3}, Ying Xiao^{1

2

3}, Zhongyi Tong⁴, Li Wang^{5

6}, Yan Hu^{7

8}

Affiliations

¹ Department of Respiratory and Critical Care Medicine, The Second Xiangya Hospital of Central South University, Changsha, China.
² Research Unit of Respiratory Disease, Central South University, Changsha, China.
³ Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, China.
⁴ Department of Pathology, The Second Xiangya Hospital of Central South University, Changsha, China.
⁵ Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha, China.
⁶ Hunan Key Laboratory of Early Diagnosis and Precision Treatment of Lung Cancer, The Second Xiangya Hospital of Central South University, Changsha, China.
⁷ Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha, China. yanhu@csu.edu.cn.
⁸ Hunan Key Laboratory of Early Diagnosis and Precision Treatment of Lung Cancer, The Second Xiangya Hospital of Central South University, Changsha, China. yanhu@csu.edu.cn.

Abstract

Background: Pulmonary sequestration (PS) is a rare congenital lower airway malformation. This study presents the clinical and imaging features and surgical outcomes of PS in adults, and compare the safety and feasibility of minimally invasive surgery versus open thoracotomy for PS.

Methods: Adult patients with PS treated at our center from July 2011 to September 2021 were included. Information regarding the patient demographics, clinical and CT features, arterial supply and venous drainage, and surgical outcomes were collected.

Results: Ninety seven patients were included. The most common CT findings were mass lesions (50.5%) and cystic lesions (20.6%). The vast majority of the lesions (96 out of 97) were located close to the spine in the lower lobes (left vs. right: 3.6 vs. 1). Arterial supply was mainly provided by the thoracic aorta (87.4%) and abdominal aorta (10.5%). Intralobar and extralobar PS accounted for 90.7% and 9.3% of the patients, respectively. Three (4.5%) patients who underwent minimally invasive surgery were converted to open thoracotomy due to dense adhesions. Though no significant differences regarding operative time (P = 0.133), the minimally invasive surgery group was significantly better than the open thoracotomy group regarding intraoperative blood loss (P = 0.001), drainage volume (P = 0.004), postoperative hospital days (P = 0.017) and duration of chest drainage (P = 0.001). There were no cases of perioperative mortality. Only four (4.1%) patients developed postoperative complications, and no significant difference existed between the two groups.

Conclusion: Our study revealed PS can present with a variety of different clinical and radiologic manifestations. Clinicians should consider the possibility of PS when diagnosing a lesion in the lower lobes close to the spine. Moreover, minimally invasive surgery is a safe and effective treatment modality for the treatment of PS in an experienced center.

Keywords: Arterial supply; CT findings; Minimal invasive surgery; Pulmonary sequestration; Thoracotomy.

MeSH terms

Adult
Bronchopulmonary Sequestration* / complications
Bronchopulmonary Sequestration* / diagnostic imaging
Bronchopulmonary Sequestration* / surgery
Humans
Lung / pathology
Retrospective Studies
Tomography, X-Ray Computed
Treatment Outcome

Abstract

MeSH terms

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