Management of pulmonary sequestration in adults; report of 27 cases

Abstract

<b>Introduction:</b> Pulmonary sequestration (PS) is a rare congenital malformation, defined as aberrant formation of segmental lung tissue that has no connection with the bronchial tree or pulmonary arteries. <b>Methods:</b> We retrospectively reviewed the records of 27 patients managed for PS in a thoracic surgery department between 1998 and 2020. <b>Results:</b> twenty-seven patients were included; 17 men and 10 women. The mean age was 35 years (18-59 years). The most reported symptoms were hemoptysis (n=10), recurrent respiratory infections (n=7), and chest pain (n=6). The discovery was on imaging tools in 5 cases. Systemic arterial supply to the PS was demonstrated with computed tomographic angiography in 22 patients (81%). Intalobar and extra lobar sequestrations were present in 23 (85%) and 4 cases (15%), respectively. The most common location was the lower lobes in 21 cases (78%). The most common feeding artery origin was the thoracic aorta in 18 cases (86%), the abdominal aorta in 6 cases (29%), the splenic artery in one case, and the celiac in two cases. Lobectomy was performed in 21 cases and sequestrectomy in 6 cases. The postoperative course was uneventful in 85 % of the cases. Secondary pneumothorax was seen in 4 cases. There was no surgical mortality. The mean of hospital stay was 7 days with a mean chest tube drainage duration of 4 days. The median duration of follow-up after surgery resection was 18 months with no complications reported. <b>Conclusion:</b> PS is a congenital lung malformation that can remain asymptomatic for a long time and appear in adulthood. Surgical resection was the standard treatment of this disease, as it serves to establish the diagnosis and prevent recurrent infectious or hemorrhagic complications.