Diagnosis and management of intradiaphragmatic extralobar pulmonary sequestration: a report of 11 cases

Hong, Chun; Yu, Gang; Zhu, Xiaohui; Jin, Tang; Xia, Bo; Wang, Limin; Cuifen, Lui

doi:10.1016/j.jpedsurg.2015.03.061

Cited by 15 publications

(32 citation statements)

References 8 publications

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“…Although CT scan has the risk of ionizing radiation, it is the most e cient choice among the compared methods to identify an IDEPS. Hong et al [5] reported that 11 cases of IDEPSs had been con rmed after birth using enhanced CT, but Olivieri et al [15] suggested that a diagnosis could only be con rmed at surgery. In our institution, the concordance rate of CT was 70% and the feeding thoracic aorta and abdominal aorta account for 50%, which were lower compaired with previous study [5,16,17] .…”

Section: Discussionmentioning

confidence: 99%

“…Hong et al [5] reported that 11 cases of IDEPSs had been con rmed after birth using enhanced CT, but Olivieri et al [15] suggested that a diagnosis could only be con rmed at surgery. In our institution, the concordance rate of CT was 70% and the feeding thoracic aorta and abdominal aorta account for 50%, which were lower compaired with previous study [5,16,17] . A 3D reconstruction software was used to provide access to more and higher-quality information about patient's 3D anatomy, making it possible to improve the accuracy and reliability of diagnosis and treatment.…”

Section: Discussionmentioning

confidence: 99%

“…IPS usually appears at the lower lobe of both lungs, especially at the left lower lobe. EPS accounting for 0.1 to 1.8% of cases is the second most common lung malformation in children [2] , and mainly locates between the left lower lobe of the lung, especially near the mediastinal spine [3] , accidentally occurs at the inner part of the diaphragm, abdomen and neck [3][4][5][6] . In same cases, IPS and EPS may co-exist [3,4] .…”

Section: Introductionmentioning

confidence: 99%

“…In same cases, IPS and EPS may co-exist [3,4] . As in EPS, Intra-diaphragmatic extralobar pulmonary sequestration (IDEPS) occurs most often on the left [3,5] , was rst reported by Caulet in 1962, and accounting for13%-18% of the PS [5,7] .…”

Section: Introductionmentioning

confidence: 99%

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Diagnosis and Surgical Treatment of Intradiaphragmatic Extralobar Pulmonary Sequestration: a Report of 10 Cases

Gao

Tan

2021

Preprint

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Background Intradiaphragmatic extralobar pulmonary sequestration(IDEPS) is a rare type of pulmonary sequestration (PS) and has been reported in very few studies. The purpose of this study is to access diagnosis and operative treatment of an IDEPS.Methods Patients with PS who were diagnosed and treated in our center from January 2015 to December 2020 were retrospectively analyzed, in order to identify patients with IDEPS. Clinical datas regarding diagnosis, surgical procedures and outcomes were documented.Results From January 2015 to December 2020, 215 patients with PS were surgically treated in our center, including 87 patients with extralobar pulmonary sequestration(EPS). 10 cases were identifed as IDEPS ( 2 males, 8 females; age, 5 months to 21 months). Prenatal ultrasounds and enhanced computed tomography (CT) showed the presence of IDEPS in 4 cases and 7 cases, respectively, and a three-dimensional (3D) reconstruction software was perfectly performed to identify the location of the lesions in 3 cases. The surgeries were smoothly performed by laparoscopic surgery in 1 case, video-assisted thoracic surgery (VATS) in 5 cases(Group 1) and Da Vinci robot-assisted thoracoscopic surgery(DVRATS) in 4 cases(Group 2). In Group 1 (5 females; the mean age, 8.0 months), the average operative duration, intraoperative blood loss volume, length of stay after operation, and postoperative thoracic catheter indwelling duration were 48 minutes, 3.8ml, 6.4 days and 2.2 days, respectively. That of Group 2(1 male, 3 females; the mean age, 9.5 months) were 80 minutes, 3.5ml, 4.3 days and 1.5 days, respectively. The IDEPS cases who followed up rang from 3 months to 36 months were included in this retrospective study and no side effect had appeared.Conclusions It’s challenging to diagnose an IDEPS through prenatal ultrasound or CT, and a 3D reconstruction software was proved to be capable to assist on the assessment of an IDEPS. We suggested early surgery to removel of an IDEPS, and the best path was accessing the mass from the chest. DVRATS or VATS for the treatment of an IDEPS is safe, feasible and effective. Furthermore, compared with VATS, DVRATS is 3D magnified view, more flexibility and precision.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Diagnosis and Surgical Treatment of Intradiaphragmatic Extralobar Pulmonary Sequestration: a Report of 10 Cases

Gao

Tan

2021

Preprint

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“…The second reason was lack of visualization in a patient with CPAM and too numerous and too voluminous cysts. 20 We excluded four case series which had less than five patients [22][23][24][25] and 13 case reports [26][27][28][29][30][31][32][33][34][35][36][37][38] from our detailed analysis. In ►Table 2, these articles are summarized with regard to entities.…”

Section: Conversionmentioning

confidence: 99%

Perioperative Complications of Video-Assisted Thoracoscopic Pulmonary Procedures in Neonates and Infants

2018

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Video-assisted thoracoscopic surgery (VATS) has gained broad acceptance among pediatric surgeons. Today, VATS can be regarded as a routine approach for various conditions in neonates and infants. However, there is a lack of information concerning the complications of thoracoscopic pulmonary surgery in neonates and infants. We aimed to review the available data. A systematic review of the literature was performed using PubMed. All publications reporting on VATS for pulmonary procedures in neonates and infants up to the age of 1 year were included. Articles were reviewed in detail for occurrence of perioperative complications and their treatment. Nine case series were eligible for analysis. Entities treated included lung sequestration, congenital pulmonary airway malformation, congenital lobar emphysema, and bronchogenic cyst. Case series reported on a total number of 135 patients. Complications occurred in 14 patients (10.4%). The major complication was an accidental transection of the middle lobar bronchus that concluded in a later resection of a prior unaffected lung lobe. Other relevant complications reported were bleeding in four patients (3.0%) and persistent air leak in four cases (3.0%). Infectious complications were reported in four patients (3.0%). Additionally, iatrogenic phrenic nerve paralysis occurred in one patient. There were no deaths related to the VATS technique. In 11 cases (8.1%), conversion to thoracotomy had been necessary. General recommendations on the treatment of complications could not be derived due to small patient numbers and lack of details of the complications reported. Reports on major complications of pulmonary VATS in neonates and infants below 1 year of age are scarce. As severe complications such as accidental bronchus transection have been described, feasibility of neonatal/infant VATS cannot be unequivocally confirmed. No literature-based recommendation can be given on the treatment of complications.

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Imaging Diagnosis for Intradiaphragmatic Pulmonary Sequestration

Hosokawa,

Tanami,

Sato

et al. 2024

J of Ultrasound Medicine

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ObjectivesExtrapulmonary sequestration (EPS) within the diaphragm (ID‐EPS) is rare and requires additional procedures such as incision or detachment of the diaphragm from the lesion for diagnosis. This study aimed to describe the imaging findings and evaluate the diagnostic accuracy of ultrasonography and computed tomography (CT) for ID‐EPS.Material and MethodsSplit diaphragm sign, shape of lesion edge, drainage vein into intra‐abdomen on ultrasound and CT, and lesion characteristics on ultrasound were compared between patients with ID‐EPS and with above‐diaphragm EPS (AD‐EPS) using Fisher's exact test.ResultsThree and nine patients were diagnosed with ID‐EPS and AD‐EPS, respectively. Significant differences were observed between the two groups in the split diaphragm sign on ultrasound (presence/absence in patients with ID‐EPS vs AD‐EPS, 2/1 vs 0/9, P = .046), shape of lesion edge on ultrasound/CT (round/beak in patients with ID‐EPS vs AD‐EPS, 3/0 vs 0/9, P = .005 on both CT and ultrasound), lesion characteristics on ultrasound (presence/absence of cystic area within lesion in patients with ID‐EPS vs AD‐EPS, 0/3 vs 7/2, P = .046), and the drainage vein into the abdomen on CT (presence/absence in patients with ID‐EPS vs AD‐EPS; 2/1 vs 0/9, P = .046). No drainage veins were visualized in the abdomen on ultrasonography and no significant differences in the presence/absence of the split‐diagram sign on CT (presence/absence in patients with ID‐EPS vs AD‐EPS and ID‐EPS; 0/3 vs 0/9, P > .999; 1/2 vs 0/9, P = .250) were observed between the two groups.ConclusionA combination of postnatal ultrasonography and CT was useful in predicting EPS located within the diaphragm.

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Diagnosis and management of intradiaphragmatic extralobar pulmonary sequestration: a report of 11 cases

Cited by 15 publications

References 8 publications

Diagnosis and Surgical Treatment of Intradiaphragmatic Extralobar Pulmonary Sequestration: a Report of 10 Cases

Diagnosis and Surgical Treatment of Intradiaphragmatic Extralobar Pulmonary Sequestration: a Report of 10 Cases

Perioperative Complications of Video-Assisted Thoracoscopic Pulmonary Procedures in Neonates and Infants

Imaging Diagnosis for Intradiaphragmatic Pulmonary Sequestration

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