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

Abstract

Rationale: Pulmonary sequestration, which can be divided into 2 main types: intralobar pulmonary sequestration (IPS) and extralobar pulmonary sequestration, is an uncommon congenital condition for which surgical resection is usually indicated. Video-assisted thoracoscopic surgery, as compared with open thoracotomy, has increasingly become the preferred operative procedure in the treatment of PS, owing to less postoperative pain and faster recovery. This report describes a rare and challenging case with a giant IPS undergoing video-assisted thoracic lobectomy. Patient concerns: A 39-year old woman suffered from recurrent pneumonia for nearly 3 years. An enhanced computed tomography scan performed in our hospital revealed a 12.0 cm × 10.0 cm-sized IPS in the left lower lobe, supplied by an 8-mm aberrant artery originating from the descending thoracic aorta. Diagnosis: Histology of the resected lobe confirmed the diagnosis of giant intralobar pulmonary sequestration associated with infection. Interventions: Thoracoscopic left lower lobectomy was performed. Outcomes: The patient has been discharged from the hospital on the ninth day after surgery with an uneventful recovery, she was in good health after a 1-year follow-up. Lessons: Although full of challenges, thoracoscopic lobectomy for giant IPS is a safe and feasible surgical procedure associated with reduced surgical trauma and postoperative pain as well as improved cosmetic results compared with traditional thoracotomy.

Robotic‐assisted thoracoscopic lobectomy for synchronous pulmonary sequestration and adenocarcinoma: A case report

“…Management options for the aberrant artery include ligation with non‐absorbable suture, clipping with clips or cutting with staplers. Hybrid operations of endovascular embolisation of the aberrant artery combined with video‐assisted thoracic surgery resection of PS have been reported to ensure the safety of the operation 6,7 . While thoracotomy was traditionally the main surgical approach, modern less‐invasive techniques have gained widespread acceptance as a safe, feasible, and effective option.…”

Case report: A unique quadruple coexisting anomaly—scimitar syndrome, atrial septal defect, vascular ring, and pulmonary sequestration

“…Preoperative endovascular embolization of large aberrant vessels is believed to be reasonable to prevent intraoperative bleeding, however, it may also cause complications ( 38 ). In contrast, when the anatomy is unclear and severe adhesions in the lower lung ligaments are present, the lobectomy can be performed first, before treatment of abnormal vessels ( 39 ).…”

Presenting a Case of an Extralobar and Extrapleural Pulmonary Sequestration in a Four-Month-Old Infant

“…ELPS appears as a well-defined mass that does not contain air on CT imaging. PS can be confused with lung cysts, lung abscesses, benign lung tumors, and lung cancer and thus has a high rate of misdiagnosis [ 19 ].…”

“…With ELPS, pedicle torsion and necrosis may require urgent surgical intervention [ 12 ]. Video-assisted thoracoscopic surgery is superior to the thoracotomy approach in terms of postoperative outcomes, hospital stay, and postoperative pain [ 10 , 19 ]. Preoperative arterial endovascular embolization [ 7 ], uniportal resection [ 18 ], and indocyanine green imaging to identify the sequestration [ 20 ] are newer adjuncts to ensure precision, safety, and minimal invasion with the best outcomes seen in asymptomatic patients.…”