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Ten-year experience in the clinical management of intralobar pulmonary sequestration in children. Pediatr Pulmonol 2023; 58:1022-1027. [PMID: 36539260 DOI: 10.1002/ppul.26287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 12/01/2022] [Accepted: 12/18/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Intralobar pulmonary sequestration (ILS) is rare and its optimal clinical management remains ambiguous. This study aimed to introduce our 10-year experience in clinical management of ILS. And the application of our novel surgical method, thoracoscopic anatomical lesion resection (TALR) on ILS was introduced. MATERIALS AND METHODS Patients with ILS who received treatment between December 2010 and 2020 were included in this study, retrospectively. A binary logistic regression model was used to assess risk factors for preoperative symptoms. Intraoperative and postoperative outcomes were compared between the thoracoscopic lobectomy and lung-sparing surgery groups. RESULTS A total of 112 patients were included in this study. Age and maximum cyst diameter were risk factors for preoperative symptoms. Lung-sparing surgery proved to be safe and feasible with no residual lesions. CONCLUSIONS The overall prognosis of early thoracoscopic surgery for ILS was good. Lung-sparing surgery, especially TALR could be used as a first-line surgery for ILS. It may resolve the long-standing controversy over whether surgery for asymptomatic patients with ILS.
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Clinical Outcomes of Transarterial Embolization in the Treatment of Pulmonary Sequestration. Cardiovasc Intervent Radiol 2021; 44:1491-1496. [PMID: 34131775 DOI: 10.1007/s00270-021-02885-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 05/27/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE To assess the safety and efficacy of transarterial embolization (TAE) for pulmonary sequestration (PS). METHODS A single-center, retrospective study was conducted from March 2013 and December 2020. Patient characteristics, laboratory/imaging, complications, and the TAE procedure were reviewed. RESULTS We report 11 symptomatic patients with PS successfully treated by TAE. The aberrant supplying arteries were embolized, and there were no immediate complications. One to three days after TAE, patients complained of mild chest pain (n = 4), moderate chest pain (n = 3), and low-grade fever (n = 1). Chest pain symptoms were completely resolved after 2-4 days. One patient with PS and bronchiectasis required thoracoscopic resection due to continued symptoms. The remaining 10 patients showed disappearance of chest pain and hemoptysis and decreased lesion size at 2 weeks and 3 months, with a clinical success rate of 90.9%. CONCLUSIONS TAE may be a feasible alternative treatment for pulmonary sequestration.
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Intralobar Pulmonary Sequestration with Anomalous Artery Arising from the Celiac Trunk. SURGERIES 2021. [DOI: 10.3390/surgeries2010009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Pulmonary saequestration is a rare congenital malformation characterized by a dysplastic portion of lung parenchyma supplied by an anomalous artery originating from the aorta or its branches. The worldwide incidence of pulmonary sequestration among all congenital lung malformations in children ranges from 1.5% to 6.4%. There are two main types of pulmonary sequestration according to the localization of the malformation, i.e., intrapulmonary sequestration (dysplastic tissue located inside a lobe of the normal lung) and extrapulmonary sequestration. Our case presentation aims to make physicians aware of this rare anomaly which may be difficult to diagnose because of its oligosymptomatic course prior to first presentation. We present the case of a 10-year-old girl who suffered from a second episode of prolonged pneumonia of the left lower lobe. Contrast-enhanced-computed-tomography (CT) scan of the thoraco-abdominal segment of the aorta and its branches revealed intrapulmonary sequestration localized at the left lower lobe of the lung. The intrapulmonary sequester was perfused by a large artery arising from the celiac trunk. The girl underwent open surgery with ligation of the anomalous feeding artery and atypical pulmonary resection of the affected area of the left lower lobe. Postoperatively, the child recovered without any complications.
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He B, Sun MS, Niu Y, Zhang JB, Nie QQ, Zheng X, Fan XQ, Liu P. Hybrid and Endovascular Treatment of Pulmonary Sequestration: Two Case Reports and Literature Review. Ann Vasc Surg 2020; 69:447.e1-447.e8. [PMID: 32745655 DOI: 10.1016/j.avsg.2020.06.066] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 06/07/2020] [Accepted: 06/27/2020] [Indexed: 11/24/2022]
Abstract
Pulmonary sequestration is an uncommon congenital pulmonary anomaly associated with aberrant systemic arteries which usually originate from the thoracic aorta or abdominal aorta. Traditionally, surgical resection and ligation of the feeding vessels are the gold standard treatments of the disease. Endovascular intervention and hybrid operation are promising treatment options. However, the case reports with endovascular and hybrid treatment are sparse to our knowledge. We presented 2 symptomatic adult patients with pulmonary sequestration successfully treated by hybrid operation and transcatheter embolization, respectively. Besides, we reviewed 37 previously reported cases of pulmonary sequestration treated by endovascular or hybrid treatment.
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Affiliation(s)
- Bin He
- Department of Cardiovascular Surgery, China-Japan Friendship Hospital, Beijing, China
| | - Ming-Sheng Sun
- Department of Cardiovascular Surgery, China-Japan Friendship Hospital, Beijing, China
| | - Yun Niu
- Department of Pathology, China-Japan Friendship Hospital, Beijing, China
| | - Jian-Bin Zhang
- Department of Cardiovascular Surgery, China-Japan Friendship Hospital, Beijing, China
| | - Qiang-Qiang Nie
- Department of Cardiovascular Surgery, China-Japan Friendship Hospital, Beijing, China
| | - Xia Zheng
- Department of Cardiovascular Surgery, China-Japan Friendship Hospital, Beijing, China
| | - Xue-Qiang Fan
- Department of Cardiovascular Surgery, China-Japan Friendship Hospital, Beijing, China.
| | - Peng Liu
- Department of Cardiovascular Surgery, China-Japan Friendship Hospital, Beijing, China.
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Khen-Dunlop N, Farmakis K, Berteloot L, Gobbo F, Stirnemann J, De Blic J, Brunelle F, Delacourt C, Revillon Y. Bronchopulmonary sequestrations in a paediatric centre: ongoing practices and debated management. Eur J Cardiothorac Surg 2018; 54:246-251. [DOI: 10.1093/ejcts/ezy049] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 01/14/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- Naziha Khen-Dunlop
- Deparmtent of Pediatric Surgery, AP-HP, Hopital Necker-Enfants malades, Paris, France
- Université Paris Descartes, Sorbonne Paris Cite, Paris, France
- EA FETUS, Paris, France
| | - Konstantinos Farmakis
- Deparmtent of Pediatric Surgery, AP-HP, Hopital Necker-Enfants malades, Paris, France
| | - Laureline Berteloot
- Deparmtent of Pediatric Radilogy, AP-HP, Hopital Necker-Enfants malades, Paris, France
| | - Francesca Gobbo
- Deparmtent of Pediatric Surgery, AP-HP, Hopital Necker-Enfants malades, Paris, France
| | - Julien Stirnemann
- Université Paris Descartes, Sorbonne Paris Cite, Paris, France
- EA FETUS, Paris, France
- Department of Obstetrics, AP-HP, Hopital Necker-Enfants malades, Paris, France
| | - Jacques De Blic
- Université Paris Descartes, Sorbonne Paris Cite, Paris, France
- Department of Pediatric Pulmunology, AP-HP, Hopital Necker-Enfants malades, Paris, France
| | - Francis Brunelle
- Université Paris Descartes, Sorbonne Paris Cite, Paris, France
- Deparmtent of Pediatric Radilogy, AP-HP, Hopital Necker-Enfants malades, Paris, France
| | - Christophe Delacourt
- Université Paris Descartes, Sorbonne Paris Cite, Paris, France
- Department of Pediatric Pulmunology, AP-HP, Hopital Necker-Enfants malades, Paris, France
| | - Yann Revillon
- Deparmtent of Pediatric Surgery, AP-HP, Hopital Necker-Enfants malades, Paris, France
- Université Paris Descartes, Sorbonne Paris Cite, Paris, France
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Mahmood H, Plumb A, Vega R, Windsor A. Incidental finding - the discovery of a bronchopulmonary foregut malformation through investigations for Crohn's disease. J Radiol Case Rep 2017; 11:10-19. [PMID: 28567181 PMCID: PMC5439451 DOI: 10.3941/jrcr.v11i4.3002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Pulmonary sequestration (PMS) is a rare bronchopulmonary malformation. It has an incidence of between 0.15% to 1.7%. Likewise, cystic adenomatoid malformation (CCAM) is another relatively rare category of a bronchopulmonary malformation with a reported incidence of between 1 in 25,000 to 1 in 35,000. Moreover, a bronchopulmonary malformation with features allied to both of these forms is considered an even rarer entity. In general, bronchopulmonary malformations present with a range of non-specific symptoms. Radiological features can be non-specific yet distinctive when related to clinical features. Ultimately, definitive diagnosis depends upon histological assessment of lung tissue. We present an adult female with radiological features of both pulmonary sequestration and cystic adenomatoid malformation. This was an incidental finding unrelated to the patients presenting complaint. This case highlights the importance of using a structured and systematic approach when interpreting medical imagery.
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Affiliation(s)
- Humza Mahmood
- Princess Alexandra Hospital, Hamstel Road, Harlow, CM20 1QX, UK
| | - Andrew Plumb
- Department of Radiology, University College Hospital, 235 Euston Road, Fitzrovia, London, NW1 2BU, UK
| | - Roser Vega
- Department of Gastrointestinal services, University College Hospital, 235 Euston Road, Fitzrovia, London, NW1 2BU, UK
| | - Alastair Windsor
- Department of Gastrointestinal services, University College Hospital, 235 Euston Road, Fitzrovia, London, NW1 2BU, UK
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Zener R, Bottoni D, Zaleski A, Fortin D, Malthaner RA, Inculet RI, Mujoomdar A. Transarterial embolization of intralobar pulmonary sequestration in a young adult with hemoptysis. J Thorac Dis 2017; 9:E188-E193. [PMID: 28449501 DOI: 10.21037/jtd.2017.02.82] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Intralobar pulmonary sequestration is a rare congenital malformation characterized by the presence of dysplastic lung that does not communicate with the tracheobronchial tree, and has aberrant systemic arterial supply. While most are asymptomatic, they rarely can present with hemoptysis, which has been traditionally managed with surgical resection of the sequestration. We report a case of an 18-year-old male who presented with acute large-volume hemoptysis on a background of recurrent minor episodes of hemoptysis, due to intralobar sequestration. He was successfully treated with transarterial embolization with a combination of polyvinyl alcohol (PVA) particles, gelfoam and coils. Transarterial embolization can be effective in managing emergent hemoptysis from pulmonary sequestration.
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Affiliation(s)
- Rebecca Zener
- Department of Medical Imaging, Western University, Victoria Hospital, London Health Sciences Centre, London, Ontario N6A 5W9, Canada
| | - David Bottoni
- Division of Thoracic Surgery, Western University, Victoria Hospital, London Health Sciences Centre, London, Ontario N6A 5W9, Canada
| | - Andrew Zaleski
- Department of Medical Imaging, Western University, Victoria Hospital, London Health Sciences Centre, London, Ontario N6A 5W9, Canada
| | - Dalilah Fortin
- Division of Thoracic Surgery, Western University, Victoria Hospital, London Health Sciences Centre, London, Ontario N6A 5W9, Canada
| | - Richard A Malthaner
- Division of Thoracic Surgery, Western University, Victoria Hospital, London Health Sciences Centre, London, Ontario N6A 5W9, Canada
| | - Richard I Inculet
- Division of Thoracic Surgery, Western University, Victoria Hospital, London Health Sciences Centre, London, Ontario N6A 5W9, Canada
| | - Amol Mujoomdar
- Department of Medical Imaging, Western University, Victoria Hospital, London Health Sciences Centre, London, Ontario N6A 5W9, Canada
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Berthod PE, Chevallier O, Pottecher P, Gehin S, Sapin E, Loffroy R. Transcatheter embolization of a large aberrant systemic artery to an intralobar pulmonary sequestration using an Amplatzer vascular plug in an adolescent. Quant Imaging Med Surg 2017; 7:152-155. [PMID: 28275570 DOI: 10.21037/qims.2016.11.04] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Pierre-Emmanuel Berthod
- Department of Vascular and Interventional Radiology, François-Mitterrand Teaching Hospital, LE2I UMR CNRS 6306, Arts et Métiers, University of Burgundy, Dijon Cedex, France
| | - Olivier Chevallier
- Department of Vascular and Interventional Radiology, François-Mitterrand Teaching Hospital, LE2I UMR CNRS 6306, Arts et Métiers, University of Burgundy, Dijon Cedex, France
| | - Pierre Pottecher
- Department of Vascular and Interventional Radiology, François-Mitterrand Teaching Hospital, LE2I UMR CNRS 6306, Arts et Métiers, University of Burgundy, Dijon Cedex, France
| | - Sophie Gehin
- Department of Vascular and Interventional Radiology, François-Mitterrand Teaching Hospital, LE2I UMR CNRS 6306, Arts et Métiers, University of Burgundy, Dijon Cedex, France
| | - Emmanuel Sapin
- Department of Pediatric Surgery, François-Mitterrand Teaching Hospital, LE2I UMR CNRS 6306, Arts et Métiers, University of Burgundy, Dijon Cedex, France
| | - Romaric Loffroy
- Department of Vascular and Interventional Radiology, François-Mitterrand Teaching Hospital, LE2I UMR CNRS 6306, Arts et Métiers, University of Burgundy, Dijon Cedex, France
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