[Pulmonary intralobar sequestration in adults: Evolution of surgical treatment]

Rev Mal Respir. 2019 Feb;36(2):129-134. doi: 10.1016/j.rmr.2018.10.008. Epub 2019 Jan 24.
[Article in French]

Abstract

Background: Until now, the traditional procedure to treat intralobar pulmonary sequestration (ILS) in adults has been a lobectomy performed by open thoracotomy. We have reviewed our data to observe if the surgical management of these lesions has evolved over the last years.

Methods: We retrospectively reviewed the records of the patients who were operated for an ILS either by posterolateral thoracotomy (PLT group), or by thoracoscopy (TS group) between 2000 and 2016.

Results: Eighteen patients were operated for a SIL during this period. Prior to 2011, all resections were performed by thoracotomy (n=6) and after 2011 the surgical approach was either a thoracotomy (n=5) or a thoracoscopy (n=7). There was one conversion because of dense pleural adhesions and this patient was integrated in the PLT group for further analysis. ILS were more frequently encountered on the left side (n=12, 66.6 %) than on the right one (n=6, 33.3 %) and exclusively in the lower lobes. All patients of the PLT group underwent a lobectomy. In the TS group, 5 patients underwent a sublobar resection (2 segmentectomiesS9+10, 1 basilar segmentectomy and 2 atypical resections). There was no mortality. In the PLT group, 5 patients (45 %) had complications versus one patient (14 %) in the TS group. The mean hospital stay was 7.4 days in the PLT group versus 5.4 days in the TS group.

Conclusions: These data confirm that ILS can be safely treated by a sublobar resection that should be performed, whenever possible, thoracoscopically.

Keywords: Pulmonary sequestration; Résection infralobaire; Segmentectomie; Segmentectomy; Sublobar resection; Séquestration pulmonaire; Thoracoscopie; Thoracoscopy.

MeSH terms

  • Adolescent
  • Adult
  • Bronchopulmonary Sequestration / epidemiology
  • Bronchopulmonary Sequestration / surgery*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pneumonectomy / adverse effects
  • Pneumonectomy / methods
  • Pneumonectomy / statistics & numerical data
  • Pneumonectomy / trends*
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Thoracic Surgery, Video-Assisted / adverse effects
  • Thoracic Surgery, Video-Assisted / methods
  • Thoracic Surgery, Video-Assisted / trends
  • Thoracotomy / adverse effects
  • Thoracotomy / methods
  • Thoracotomy / statistics & numerical data
  • Thoracotomy / trends
  • Treatment Outcome
  • Young Adult