Diagnosis and treatment of 131 adult patients with bronchopulmonary sequestration: A retrospective analysis_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

GU Xiaobo ^1,2 , CHEN Qiankun ² , WAN Ziwei ² , YE Cong ² ,  ZHU Yuming ² ,  DU Shijian ¹

1. Department of Thoracic Surgery, Wenjiang Branch of Sichuan Province People's Hospital, The People’s Hospital of Wenjiang District, Chengdu, 644100, P. R. China;
2. Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University, Shanghai, 200433, P. R. China;

Corresponding author：

ZHU Yuming, Email: Ymzhu2005@aliyun.com; DU Shijian, Email: 494460620@qq.com

Keywords：

Bronchopulmonary sequestration; uni-portal video-assisted thoracic surgery; thoracotomy

DOI：

10.7507/1007-4848.202203028

Video：

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Objective To explore the safety and feasibility of uni-portal video-assisted thoracic surgery (VATS) for the treatment of bronchopulmonary sequestration (BPS). Methods The clinical data of BPS patients with surgical resection in Shanghai Pulmonary Hospital from February 2010 to June 2021 were reviewed. The patients were divided into a VATS group and a thoracotomy group according to the operation method. The operation time, intraoperative blood loss, hospital stay and postoperative complication rate were compared between the two groups. The VATS group was subdivided into a uni-portal VATS group and a multi-portal VATS group for subgroup analysis. Results Finally 131 patients were enrolled, including 62 males and 69 females with an average age of 39.3±13.2 years. There were 103 patients in the VATS group and 28 patients in the thoracotomy group. A total of 104 patients were diagnosed with left lower BPS, 26 with right lower BPS and 1 with bilateral lower BPS. The main symptom was cough (88 patients, 67.2%). There were 119 patients diagnosed by thoracic enhanced CT before operation. Compared with the thoracotomy group, the operation time was not statistically different (P=0.717), but the blood loss was less, the rate of postoperative complication was lower and hospital stay was shorter in the VATS group (P＜0.05). The rate of conversion to open surgery in the uni-portal VATS group and multi-portal VATS group was 11.8% and 13.5%, respectively. Meanwhile, patients in the uni-portal VATS group had shorter operation time and postoperative hospital stay, less blood loss and lower postoperative complication rate than those in the multi-portal VATS group (P＜0.05). Conclusion In order to improve the rate of diagnosis, the lung enhanced CT scan should be selected as an optimal noninvasive method in adult suspected patients (especially those with solid cystic and solid lesions in the lower lobe). Uni-portal VATS is a safe and feasible method for BPS which can be widely promoted.

Citation： GU Xiaobo, CHEN Qiankun, WAN Ziwei, YE Cong, ZHU Yuming, DU Shijian. Diagnosis and treatment of 131 adult patients with bronchopulmonary sequestration: A retrospective analysis. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2024, 31(1): 105-110. doi: 10.7507/1007-4848.202203028 Copy

1.	Sihoe ADL, Luo QG, Shao GQ, et al. Uniportal thoracoscopic lobectomy for intralobar pulmonary sequestration. J Cardiothorac Surg, 2016, 11: 27.
2.	Zhang N, Zeng Q, Chen CH, et al. Distribution, diagnosis, and treatment of pulmonary sequestration: Report of 208 cases. J pediatr Surg, 2019, 54(7): 1286-1292.
3.	Zhang SX, Wang HD, Yang K, et al. Retrospective review of the diagnosis and treatment of pulmonary sequestration in 28 patients: Surgery or endovascular techniques? J Thorac Dis, 2017, 9(12): 5153-5160.
4.	Hong C, Yu G, Tang J, et al. Risk analysis and outcomes of bronchopulmonary sequestrations. Pediatr Surg Int, 2017, 33(9): 971-975.
5.	谢明汛, 龚明福, 张冬, 等. 增强CT扫描及后处理技术对肺隔离症的诊断价值. 中华肺部疾病杂志(电子版), 2017, 10(5): 530-533.
6.	吴立共, 李求久, 毛梦叶, 等. 肺隔离症诊断中CT与高分辨率MRI序列的临床价值研究. 医院管理论坛, 2021, 38(8): 49-51.
7.	Pryce DM. Lower accessory pulmonary artery with intralobar sequestration of lung; a report of seven cases. J Pathol Bacteriol, 1946, 58(3): 457-467.
8.	Wei Y, Li F. Pulmonary sequestration: A retrospective analysis of 2625 cases in China. Eur J Cardiothorac Surg, 2011, 40(1): e39-e42.
9.	张志刚, 何权瀛. 肺隔离症误诊分析. 中国呼吸与危重监护杂志, 2016, 15(4): 394-397.
10.	Petty L, Joseph A, Sanchez J, et al. Case report: Pulmonary sequestration in an adult. Radiol Case Rep, 2017, 13(1): 21-23.
11.	Ganarin A, Sgrò A, Garcia Magne M, et al. Thoracoscopy versus thoracotomy for congenital lung malformations treatment: A single center experience. Pediatr Pulmonol. 2021, 56(1): 196-202.
12.	王俊峰, 代雨, 付玉东, 等. 全胸腔镜与开胸手术治疗肺隔离症的疗效对比. 中国微创外科杂志, 2017, 17(4): 325-328.
13.	Li XK, Luo J, Wu WJ, et al. Effect of different therapeutic strategies on the clinical outcome of asymptomatic intralobar pulmonary sequestration. Interact Cardiovasc Thorac Surg, 2019, 29(5): 706-713.
14.	Traibi A, Seguin-Givelet A, Brian E, et al. Adult pulmonary intralobar sequestrations: Changes in the surgical management. J Vis Surg, 2018, 4: 62.
15.	Gonzalez-Rivas D, Paradela M, Fernandez R, et al. Uniportal video-assisted thoracoscopic lobectomy: Two years of experience. Ann Thorac Surg, 2013, 95(2): 426-432.
16.	Sihoe AD. The evolution of minimally invasive thoracic surgery: Implications for the practice of uniportal thoracoscopic surgery. J Thorac Dis, 2014, 6(6): S604-S617.
17.	Bertolaccini L, Rocco G, Viti A, et al. Geometrical characteristics of uniportal VATS. J Thorac Dis, 2013, 5(3): S214-S216.
18.	Dell Amore A, Giunta D, Campisi A, et al. Uniportal thoracoscopic resection of intralobar and extralobar pulmonary sequestration. J Vis Surg, 2018, 4: 63.
19.	曹敏, 傅于捷, 赵晓菁. 单孔胸腔镜治疗肺隔离症15例报道. 上海交通大学学报(医学版), 2020, 40(3): 413-416.
20.	Lin TH, Huang WL, Chang CC, et al. Uniportal video-assisted thoracoscopic surgery lobectomy and segmentectomy for pulmonary sequestration. J Thorac Dis, 2018, 10(6): 3722-3728.

1. Sihoe ADL, Luo QG, Shao GQ, et al. Uniportal thoracoscopic lobectomy for intralobar pulmonary sequestration. J Cardiothorac Surg, 2016, 11: 27.
2. Zhang N, Zeng Q, Chen CH, et al. Distribution, diagnosis, and treatment of pulmonary sequestration: Report of 208 cases. J pediatr Surg, 2019, 54(7): 1286-1292.
3. Zhang SX, Wang HD, Yang K, et al. Retrospective review of the diagnosis and treatment of pulmonary sequestration in 28 patients: Surgery or endovascular techniques? J Thorac Dis, 2017, 9(12): 5153-5160.
4. Hong C, Yu G, Tang J, et al. Risk analysis and outcomes of bronchopulmonary sequestrations. Pediatr Surg Int, 2017, 33(9): 971-975.
5. 谢明汛, 龚明福, 张冬, 等. 增强CT扫描及后处理技术对肺隔离症的诊断价值. 中华肺部疾病杂志(电子版), 2017, 10(5): 530-533.
6. 吴立共, 李求久, 毛梦叶, 等. 肺隔离症诊断中CT与高分辨率MRI序列的临床价值研究. 医院管理论坛, 2021, 38(8): 49-51.
7. Pryce DM. Lower accessory pulmonary artery with intralobar sequestration of lung; a report of seven cases. J Pathol Bacteriol, 1946, 58(3): 457-467.
8. Wei Y, Li F. Pulmonary sequestration: A retrospective analysis of 2625 cases in China. Eur J Cardiothorac Surg, 2011, 40(1): e39-e42.
9. 张志刚, 何权瀛. 肺隔离症误诊分析. 中国呼吸与危重监护杂志, 2016, 15(4): 394-397.
10. Petty L, Joseph A, Sanchez J, et al. Case report: Pulmonary sequestration in an adult. Radiol Case Rep, 2017, 13(1): 21-23.
11. Ganarin A, Sgrò A, Garcia Magne M, et al. Thoracoscopy versus thoracotomy for congenital lung malformations treatment: A single center experience. Pediatr Pulmonol. 2021, 56(1): 196-202.
12. 王俊峰, 代雨, 付玉东, 等. 全胸腔镜与开胸手术治疗肺隔离症的疗效对比. 中国微创外科杂志, 2017, 17(4): 325-328.
13. Li XK, Luo J, Wu WJ, et al. Effect of different therapeutic strategies on the clinical outcome of asymptomatic intralobar pulmonary sequestration. Interact Cardiovasc Thorac Surg, 2019, 29(5): 706-713.
14. Traibi A, Seguin-Givelet A, Brian E, et al. Adult pulmonary intralobar sequestrations: Changes in the surgical management. J Vis Surg, 2018, 4: 62.
15. Gonzalez-Rivas D, Paradela M, Fernandez R, et al. Uniportal video-assisted thoracoscopic lobectomy: Two years of experience. Ann Thorac Surg, 2013, 95(2): 426-432.
16. Sihoe AD. The evolution of minimally invasive thoracic surgery: Implications for the practice of uniportal thoracoscopic surgery. J Thorac Dis, 2014, 6(6): S604-S617.
17. Bertolaccini L, Rocco G, Viti A, et al. Geometrical characteristics of uniportal VATS. J Thorac Dis, 2013, 5(3): S214-S216.
18. Dell Amore A, Giunta D, Campisi A, et al. Uniportal thoracoscopic resection of intralobar and extralobar pulmonary sequestration. J Vis Surg, 2018, 4: 63.
19. 曹敏, 傅于捷, 赵晓菁. 单孔胸腔镜治疗肺隔离症15例报道. 上海交通大学学报(医学版), 2020, 40(3): 413-416.
20. Lin TH, Huang WL, Chang CC, et al. Uniportal video-assisted thoracoscopic surgery lobectomy and segmentectomy for pulmonary sequestration. J Thorac Dis, 2018, 10(6): 3722-3728.

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