Clinical features of two types of pulmonary sequestration: retrospective analysis of 208 cases

Abstract

Objective To summarize the clinical outcomes and differences for two subtypes of pulmonary sequestration (PS). Methods We retrospectively reviewed 208 patients undergoing surgery for PS at our institution between 2005 and 2017. There were 138 boys and 70 girls. All of them were operated successfully without surgical mortality and their etiologies pathologically confirmed postoperatively. They were divided into three types of intralobar sequestration, extralobar sequestration and bilateral sequestrations according to preoperative scans of enhanced computed tomography. The mean age was 19.7±48.82 (1/12-168) months. Demographic profiles, surgical approaches, preoperative symptoms and complications were collected from medical records. Results The mean operative duration was (70±48.75)(10-230) min and the mean volume of blood loss (5±18)(1-200) ml. Arterial supply was predominantly provided by branches of thoracic or abdominal aorta. The veins of sequestration were drained into pulmonary, azygos and hemizygos veins. Among 143 intralobar sequestrations and 3 bilateral sequestrations, lobectomy (n=112) and segmental lobectomy (n=34) were performed. All cases of extralobar sequestration underwent lesional lobectomy. Statistically significant differences existed in venous return, symptomatic and lesion sites between patients with intraplantar and extralobar PS. Conclusions PS patients may be detected by preterm ultrasonography. The most useful diagnostic methods for pulmonary sequestration are CT angiography (CTA) and magnetic resonance imaging (MRI). Significant distinctions exist in lesion region, arterial supply and venous drainage between different types of pulmonary sequestrations. Key words: Pulmonary sequestration; Video-assisted thoracic surgery; Diagnosis