One-Stage Laparoscopic Surgery for Pulmonary Sequestration and Hiatal Hernia in a 2-Year-Old Girl.

Momoko Ara,Hiromi Hamada,Shohei Honda,Hisayuki Miyagi,Masashi Minato,Akinobu Taketomi

doi:10.1055/s-0037-1612611

Abstract

We herein report a case of one-stage laparoscopic surgery for extralobar pulmonary sequestration (EPS) and hiatal hernia. Our patient was a 2-year-old girl who was diagnosed as a mediastinal mass lesion. Postnatal computed tomography revealed that the mediastinal mass was an EPS. Two weeks after birth, the patient developed gastroesophageal reflux (GER), and esophagography showed a hiatal hernia. At 2 years of age, she underwent one-stage laparoscopic Nissen's fundoplication for GER with resection of the EPS in the posterior mediastinum. The sequestrated lung was grasped via the esophageal hiatus; three aberrant blood vessels were dissected to allow removal of the sequestration through the umbilical port site. The esophageal hiatus was repaired and Nissen's fundoplication was performed laparoscopically. The patient's postoperative course was uneventful, with no recurrence of GER symptoms for 1 year. We conclude that one-stage laparoscopic surgery is useful for patients with EPS and hiatal hernia.

Highlights

Extralobar pulmonary sequestration (EPS) is a rare congenital lung anomaly, it is the second most common lung malformation in children, accounting for 0.1 to 1.8% of cases.[1]The origin of the condition remains uncertain; the available evidence suggests that it results from accessory lung tissue arising from the foregut.[1,2] extralobar pulmonary sequestration (EPS) is located in the mediastinum in approximately 5% of cases.[2]
One-stage laparoscopic surgery is useful for patients with hiatal hernia and EPS, especially when the EPS is located in the posterior mediastinum near the diaphragm
At 2 years of age, the patient underwent one-stage laparoscopic Nissen’s fundoplication for treatment of the gastroesophageal reflux (GER) and resection of the EPS in the posterior mediastinum because she sometimes experienced nausea and we considered that the EPS might be associated with this symptom

Summary

Introduction

Extralobar pulmonary sequestration (EPS) is a rare congenital lung anomaly, it is the second most common lung malformation in children, accounting for 0.1 to 1.8% of cases.[1]The origin of the condition remains uncertain; the available evidence suggests that it results from accessory lung tissue arising from the foregut.[1,2] EPS is located in the mediastinum in approximately 5% of cases.[2]. Keywords ► pulmonary sequestration ► hiatal hernia ► gastroesophageal reflux ► laparoscopic ► one-stage We report a case of one-stage laparoscopic surgery for extralobar pulmonary sequestration (EPS) and hiatal hernia.

Results

Conclusion