[Endoscopic lobectomy for 47 children with pulmonary sequestration].

Abstract

To evaluate the feasibility of endoscopic lobectomy for pulmonary sequestration in children. Clinical data of 47 children with pulmonary sequestration treated with endoscopic lobectomy from April 2015 to November 2017 were reviewed. According to the operation date, 19 children received operation from April 2015 to December 2016 were early group, and 23 children received operation from January 2017 to November 2017 were late group (5 children with lesions inside diaphragm were excluded). The operation time, intraoperative blood loss, retention time of drainage tube, length of hospital stay and incidence of complications were compared between two groups. Among 47 children, endoscopic lobectomy was successfully completed in 45 children, and the rest 2 children were converted to thoracotomy. No death was observed. The operation time in late group was shorter than that in the early group (P<0.05), and the intraoperative blood loss of the late group was less than that of early group (P<0.05); while there were no significant differences in retention time of drainage tube and length of hospital stay between two groups (both P>0.05). Postoperative complications occurred in 14 children, including 4 cases of pneumothorax, 8 cases of pleural effusion, 1 case of pulmonary infection, and 1 case of diaphragmatic hernia. The incidence rates of postoperative complications in late group and early group were 17.4% (4/23) and 42.1% (8/19), and the difference was not statistically significant(P>0.05). During the follow-up (2-26 months), no relapse and thoracic collapes were observed, and CT examination found that the remaining lungs were well compensated in all children. The endoscopic lobectomy is effective and safe with less trauma and bleeding, which is recommended for treatment of pulmonary sequestration in children.