Feasibility investigation of uniportal video-assisted thoracoscopic anatomical lung resection for pulmonary sequestration

Abstract

Background: Uniportal video-assisted thoracic surgery (UVATS) technique has been increasingly used for many thoracic diseases. Whether UVATS has equivalent or better perioperative outcomes for pulmonary sequestration (PS) patients remains controversial. Our study aimed to evaluate the feasibility of UVATS in anatomical lung resection for pulmonary sequestration. Methods: A total of 24 patients with PS including fifteen males and nine females with the mean age of 40 (range, 18-65) years old, who had received completely UVATS anatomical lung resection for PS in Nanjing Chest Hospital between January 2016 and December 2018 were retrospectively reviewed. Related clinical data were retrieved from hospital records and analyzed. Results: All 24 patients had been treated with the UAVTS approach successfully without aberrant artery ruptured or massive hemorrhage, and no patients died during the perioperative period. Overall mean surgery time was 102 mins (range, 55-150 min), the mean blood loss was 94 ml (range, 10-300 ml), the mean days of chest tube maintained were 4 days (range,1-10 days), and the mean postoperative hospitalization days was 6 days (range,2-11 days). All patients were cured, without cough, fever, hemoptysis, and so on, associated with PS, occurring during the average follow-up of 17 months (range, 3-35 months). Conclusions: Our preliminary results revealed that anatomical lung resection by UVATS is a safe and feasible miniinvasive technique for PS patients, which might be associated with less postoperative pain, reduced paresthesia, better cosmetic results, and faster recovery.

Imaging and pathological characteristics, treatment, and prognosis of pulmonary sequestration—A retrospective study of 13 cases

“…Either thoracoscopic lobectomy, thoracoscopic wedge resection of the lesion, or thoracoscopic anatomical segmentectomy can be selected. 20,31,32 However, regardless of the type of pulmonary sequestration, the key to the operation is to correctly identify abnormal blood supply vessels and select the appropriate method to disconnect the abnormal blood vessels, thereby reducing the risk of intraoperative bleeding. Conservative treatment of pulmonary sequestration not only has a poor therapeutic effect but also increases long-term complications and surgical risks.…”

“…For intralobar pulmonary sequestration, the surgical plan can be discussed based on imaging results. Either thoracoscopic lobectomy, thoracoscopic wedge resection of the lesion, or thoracoscopic anatomical segmentectomy can be selected 20,31,32 . However, regardless of the type of pulmonary sequestration, the key to the operation is to correctly identify abnormal blood supply vessels and select the appropriate method to disconnect the abnormal blood vessels, thereby reducing the risk of intraoperative bleeding.…”

Video-assisted thoracoscopic surgery lobectomy for giant intralobar pulmonary sequestration: A case report

“…Pulmonary sequestration (PS) has been classified into 2 types: the intralobar type, wherein the segment is located in the normal pulmonary parenchyma without its own pleural covering, and the extralobar type, which is an isolated segment with its own pleural envelope. [ 4 ] The clinical manifestations of this disease lack specificity. The severity of symptoms is related to the size of the lung lesions and whether it is co-infected.…”