Pulmonary sequestration in adult patients: a single-center retrospective study

Abstract

<b>Background:</b> Pulmonary sequestration (PS) is a rare congenital airway malformation. This study presents the clinical and imaging features of PS in adults and compares the safety and feasibility of minimally invasive surgery versus open thoracotomy. <b>Methods:</b> Adult patients with PS from 2011 to 2021 were included. Data regarding the patient demographics, clinical and CT features, arterial supply, and surgical outcomes were collected. <b>Results:</b> 97 patients were included. The most common CT findings were mass lesions (50.5%) and cystic lesions (20.6%). The vast majority of the lesions (96 of 97) were located close to the spine in the lower lobes (left vs right: 3.6 vs. 1). Arterial supply was mainly provided by the thoracic aorta (87.4%) and abdominal aorta (10.5%).&nbsp;Intralobar and extralobar PS accounted for 90.7% and 9.3% of the patients, respectively.&nbsp;Three (4.5%) patients who underwent minimally invasive surgery were converted to open thoracotomy due to dense adhesions. Though no significant differences regarding operative time (P= 0.133), the minimally invasive surgery group was significantly better than the open thoracotomy group regarding intraoperative blood loss (P= 0.001), drainage volume (P= 0.004), postoperative hospital days (P= 0.017) and chest tube duration (P= 0.001). There were no cases of perioperative mortality. Only four (4.1%) patients developed postoperative complications, and no significant difference existed between the two groups (P=0.399). All 67 patients who received follow-up did not develop PS-related complications or relapse during a median follow-up time of 31 months. <b>Conclusion:</b> Minimally invasive surgery is a safe and effective treatment modality for PS in an experienced center.