Embolization versus surgical resection of pulmonary sequestration: Clinical experiences with a thoracoscopic approach

Cho, Min Jeng; Kim, Dae Yeon; Kim, Seong Chul; Kim, Ki-Soo; Kim, Ellen Ai‐Rhan; Lee, Byong Sop

doi:10.1016/j.jpedsurg.2012.09.013

Cited by 60 publications

(62 citation statements)

References 24 publications

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“…Recently, therapeutic embolization has been reported as an alternative method to surgical resection especially in neonates and children. [16,17] Goto et al [18] reported coil embolization as a safe, feasible, and effective method before surgery to prevent intraoperative bleeding from aberrant arteries. Neither therapeutic nor preventive coil embolization was performed in our clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Surgical approach in pulmonary sequestrations: An institutional experience with 32 cases

Özkan¹

2017

Turk Gogus Kalp Dama

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ÖZAmaç: Bu çalışmada, pulmoner sekestrasyonların cerrahi tedavisi hakkında deneyimlerimiz sunuldu. Ça lış ma pla nı: Pulmoner sekestrasyon nedeniyle Ocak 1987 -Aralık 2015 tarihleri arasında cerrahi rezeksiyon uygulanan toplam 32 hasta (16 erkek, 16 kadın; ort. yaş 32.7±13.4 yıl; dağılım 4-61 yıl) incelendi. Hastalar demografik özellikleri, semptomlar, tanı yöntemleri, pulmoner sekestrasyonun tipi, yerleşim yeri ve vasküler özellikleri, rezeksiyon tipi, komplikasyonlar ve sonuçlara göre değerlendirildi. Bul gu lar: Hastaların %87.5'inde intralober, %12.5'inde ekstralober sekestrasyon saptandı. Intralober sekestrasyon hastaların %89.3'ünde alt lob, %10.7'sinde üst lob yerleşimli idi. Bütün ekstralober sekestrasyonlar sol hemitoraksta olmak üzere; %75'i hemitoraks tabanı, %25'i ise apeks yerleşimli idi. Hastaların %53.1'ine lobektomi, %25'ine kama rezeksiyon, %12.5'ine kütle eksizyonu, %9.4'üne segmentektomi uygulandı. Ameliyat sonrası komplikasyonlar üç hastada uzamış hava kaçağı, iki hastada yara yeri enfeksiyonu ve bir hastada ampiyem olmak üzere hastaların %18.8'inde gelişti. Mortalite izlenmedi. Ortanca takip süresi 42 ay (dağılım 3-105 ay) idi ve hastaların asemptomatik kaldığı saptandı. So nuç: Pulmoner sekestrasyon benign seyirli olmasına rağmen ciddi komplikasyonları nedeni ile hastalar asemptomatik olsa da çıkarılmalıdır. Bilgisayarlı tomografik anjiyografi pulmoner sekestrasyonlara yaklaşımda cerraha yol gösteren iyi bir tanı aracıdır.Anah tar söz cük ler: Bilgisayarlı tomografik anjiyografi; pulmoner sekestrasyon; cerrahi. ABSTRACTBackground:This study aims to present our experiences on surgical treatment of pulmonary sequestrations. Methods: A total of 32 patients (16 males, 16 females; mean age 32.7±13.4 years; range 4 to 61 years) who were performed surgical resection for pulmonary sequestration between January 1987 and December 2015 were reviewed. Patients were evaluated according to demographics, symptoms, diagnostic methods, type, localization and vascular characteristics of pulmonary sequestration, type of resection, complications, and outcomes. Results:Of the patients, intralobar sequestration was detected in 87.5% and extralobar sequestration in 12.5%. Intralobar sequestration was located in the lower lobe in 89.3% and in the upper lobe in 10.7% of the patients. All extralobar sequestrations were located in the left hemithorax; 75% was located at the base of the hemithorax and 25% was located at the apex. Of the patients, lobectomy was performed in 53.1%, wedge resection in 25%, mass excision in 12.5%, and segmentectomy in 9.4%. Postoperative complications occurred in 18.8% of the patients as prolonged air leak in three patients, wound infection in two patients, and empyema in one patient. No mortality was observed. Median follow-up period was 42 months (range 3 to 105 months) and we detected that patients remained asymptomatic. Conclusion: Although pulmonary sequestration has a benign course, it should be removed owing to its severe complications even if patients are asymptomatic. Computed to...

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Section: Discussionmentioning

confidence: 99%

Surgical approach in pulmonary sequestrations: An institutional experience with 32 cases

Özkan¹

2017

Turk Gogus Kalp Dama

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“…Lung parenchyma surrounding an ILS may show emphysematous changes. The aberrant systemic artery supplying the lesion usually arises from the descending thoracic or upper abdominal aorta, and less commonly from intercostals, internal thoracic, subclavian or even The definite treatment is surgical, though endovascular embolization has been attempted, especially for ELS [51,52]. Thoracotomy or thoracoscopic surgery may be done, and while ELS can be managed by sequestrectomy, lobectomy is usually needed for intralobar cases.…”

Section: Pulmonary Sequestrationmentioning

confidence: 99%

Congenital Malformations and Developmental Anomalies of the Lung

2014

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Congenital malformations of the lung are a group of diverse, yet related, abnormalities which may involve the lung parenchyma, pulmonary vasculature, or a combination of both. They may be detected in fetal life, produce severe symptoms during infancy, or may not manifest symptomatically until adulthood. The goal of imaging is to demonstrate the various components of the malformation, to facilitate appropriate management. This article discusses the spectrum of congenital and developmental lung anomalies, their etio-pathogenesis, role of various imaging modalities, and characteristic radiological findings.

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“…Las opciones terapéuticas son la cirugía convencional y la laparoscópica, técnica segura y factible en recién nacidos y lactantes menores. También se ha indicado a la embolización de la arteria nutricia como una alternativa terapéutica a la exéresis quirúrgi-ca 16,17 , aunque algunos autores descartan esta posibilidad dado los riesgos de infección y las complicaciones propias de la embolización arterial 18 . El abordaje laparoscópico cuenta con la ventaja adicional de ser menos doloroso y no requerir drenaje pleural en el postoperatorio 19 .…”

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Pulmonarysequestration in new born

Amarilla

Maldonado

2016

Rev. Nac. (Itauguá)

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RESUMENSe presenta caso de recién nacido de 36 semanas de gestación, primer gemelar, con distrés respiratorio en las primeras horas de vida, requiriendo intubación y pasando a Unidad de Cuidados Intensivos, siendo remitido al Servicio de Cirugía Pediátrica tras constatarse opacidad en base pulmonar izquierda por radiología. Palabras claves: Secuestro pulmonar ABSTRACT A new born case of 36 weeks gestation is presented, the first twin with respiratory distress in the first hours of life passing by requiring intubation and intensive care unit, being referred to our institution after confirming opacity in the left lung base by radiology. Keywords: Pulmonary sequestration INTRODUCCION El secuestro pulmonar se define como una masa o segmento de pulmón no funcionante, sin comunicación con el árbol traqueobronquial y con irrigación propia proveniente de vasos sistémicos anómalos 1 . El defecto se produce hacia la 7ª u 8ª semana de gestación, de un brote separado o segmento pulmonar que perdió su conexión con el árbol bronquial 2 . Si esta separación ocurre antes que se forme la pleura, el secuestro será adyacente al pulmón normal y estará rodeado por la misma pleura (secuestro intralobar). Si la separación sucede después, entonces el secuestro tendrá su propia pleura (secuestro extralobar) 3 . Este último, a su vez, puede tener localización extratorácica (a nivel diafragmático o infradiafragmático), pudiendo estar asociado con otras anomalías 4 , principalmente con la hernia diafragmática congénita, atribuida a una interferencia con el cierre normal del canal pleuroperitoneal por la masa 5,6 . Los secuestros extralobares son los más frecuentes, aproximadamente 90% de los casos, con más frecuencia en el hemitórax izquierdo, localizándose en el lóbulo inferior, con vascularización propia proveniente de la aorta infradiafragmàtica 5 . Otros mencionan al secuestro intralobar como el más frecuente, en un 75% de los casos 6 . El diagnóstico inicial puede realizarse en la etapa prenatal a través de la ecografía, caracterizado por la presencia de masa ecogé-nica y homogénea, bien circunscripta, de forma lobular o triangular, volumen variable, pudiendo identificarse a partir del 2º. trimestre de gestación 7 . Una vez que se sospecha el diagnóstico se debe tratar de identificar la circulación arterial mediante Doppler color. Esto es importante ya que las otras lesiones (malformación adenomatoidea, quiste broncogénico, enfisema lobar) obtienen su irrigación de los vasos pulmonares 8 . Una particularidad que tiene esta patología es la variabilidad en su presentación, pues se han reportado casos de los 2 tipos en un mismo paciente, coincidiendo a veces en un mismo pulmón o separados 9,10,11 , así como casos de secuestro pulmonar total unilateral 12 . En la etapa postnatal, el estudio de elección es la angiotomografía, que revela una opacidad homogénea 6 que rara vez contiene aire 9 , pudiendo apreciarse la arteria nutricia de origen sistémico. Asimismo, permite la planificación del tratamiento por su gran precisión, sensibilidad...

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Embolization versus surgical resection of pulmonary sequestration: Clinical experiences with a thoracoscopic approach

Cited by 60 publications

References 24 publications

Surgical approach in pulmonary sequestrations: An institutional experience with 32 cases

Surgical approach in pulmonary sequestrations: An institutional experience with 32 cases

Congenital Malformations and Developmental Anomalies of the Lung

Pulmonarysequestration in new born

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