Uniportal Video-Assisted Thoracoscopic Resection and Lobectomy for Infants With Pulmonary Sequestration: Case Series and Initial Experience

Jin-Xi Huang,Jun-Jie Hong,Song-Ming Hong,Qiang Chen,Hua Cao

doi:10.3389/fped.2021.798342

Abstract

Background: The present study aimed to evaluate the safety and feasibility of uniportal video-assisted thoracoscopic surgery (U-VATS) for infants with pulmonary sequestration (PS).Methods: From January 2019 to July 2020, 19 infants with PS were admitted to a provincial hospital in the Fujian Province of China. A 1.5-cm utility port was created in the fifth intercostal space at the anterior axillary line. A rigid 30° 5-mm optic thoracoscope was used for vision, and two or three instruments were utilized through the port. Surgical options include standard lobectomy, wedge resection, and resection of the extralobar sequestration. Only one intercostal space was entered, and a chest tube was inserted through the same skin incision if necessary.Results: The procedure was successful in all patients with an average operation duration of 58.3 ± 31.5 min. The length of post-operative hospital stay was 5.4 ± 1.5 days, and no post-operative deaths or serious complications were observed. The mean post-operative drainage volume was 164.6 ± 45.9 mL, and the mean post-operative thoracic tube indwelling duration was 5.5 ± 1.0 days. No intraoperative conversion, surgical mortality, or major complications were identified among the patients.Conclusion: Our preliminary experience presented a series of U-VATS lobectomy, wedge resection, and resection of the PS for infants with satisfactory perioperative results.

Highlights

Pulmonary sequestration (PS) is the second most common type of congenital dysplasia of the lungs and a non-functioning lung mass with an abnormal connection to tracheobronchial trees and an anomalous systemic artery supply [1, 2]
The present study aimed to evaluate the safety and feasibility of uniportal video-assisted thoracoscopic surgery (U-Video-assisted thoracoscopic surgery (VATS)) for infants with pulmonary sequestration (PS)
Our preliminary experience presented a series of U-VATS lobectomy, wedge resection, and resection of the PS for infants with satisfactory perioperative results

Summary

Introduction

Pulmonary sequestration (PS) is the second most common type of congenital dysplasia of the lungs and a non-functioning lung mass with an abnormal connection to tracheobronchial trees and an anomalous systemic artery supply [1, 2]. The two subtypes of PS are intralobar sequestration (ILS) and extralobar sequestration (ELS). Patients with PS usually manifest upper airway syndrome, hemoptysis, or repeated lung infections [2]. The infection rate in children with ILS was 71.17%, and that in children with ELS was 31.37% [3]. Video-assisted thoracoscopic surgery (VATS) is a common and effective surgical method for PS, and lobectomy and lung-sparing resection are the two major operative approaches [3, 4]. The present study aimed to evaluate the safety and feasibility of uniportal video-assisted thoracoscopic surgery (U-VATS) for infants with pulmonary sequestration (PS)

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Results

Discussion

Conclusion