1
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Wang XX, Zhang HS, Sui YX, Liu J. Intralobular pulmonary sequestration of the right upper lobe supplied by ascending aorta. INTERDISCIPLINARY CARDIOVASCULAR AND THORACIC SURGERY 2023; 37:ivad124. [PMID: 37522880 PMCID: PMC10409889 DOI: 10.1093/icvts/ivad124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/17/2023] [Accepted: 08/05/2023] [Indexed: 08/01/2023]
Abstract
Pulmonary sequestration (PS) is a rare congenital lung malformation that is more common in the left lower lobe. In 95% of cases, the artery supplying the sequestration usually originates from the thoracic and abdominal aorta. We report a rare intralobular PS case for a feeding artery from the ascending aorta. Angio-computed tomography should be performed for diagnosis once PS is suspected.
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Affiliation(s)
- Xiao-Xia Wang
- Department of Clinical Oncology, Weihai Central Hospital, The Affiliated Hospital of Qingdao University, Shandong, China
| | - Hong-Sheng Zhang
- Department of Radiology, Weihai Central Hospital, The Affiliated Hospital of Qingdao University, Shandong, China
| | - Yun-Xia Sui
- Department of Clinical Oncology, Weihai Central Hospital, The Affiliated Hospital of Qingdao University, Shandong, China
| | - Jie Liu
- Department of Radiology, Weihai Central Hospital, The Affiliated Hospital of Qingdao University, Shandong, China
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2
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Abu Zahira I, Haddad RN, Meot M, Bonnet D, Malekzadeh-Milani S. Transcatheter Management of Pulmonary Sequestrations in Children-A Single-Center Experience. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1197. [PMID: 37508694 PMCID: PMC10378210 DOI: 10.3390/children10071197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/26/2023] [Accepted: 07/03/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND A pulmonary sequestration (PS) is an area of bronchopulmonary tissue with aberrant arterial supply. Transcatheter occlusion of PSs is an appealing treatment option, but data on outcomes remain scarce. We aim to describe our experience with transcatheter management of PS in infants and children. METHODS Retrospective review of clinical data of all patients with suspected PS sent for diagnostic and/or interventional cardiac catheterization at our institution between January 1999 and May 2021. Procedural considerations, techniques, standard safety, and outcomes were assessed. RESULTS We identified 71 patients (52.1% males), with median age and weight of 4.9 months (IQR, 2.1-26.6) and 4.2 kg (IQR, 3.9-12.1), respectively. Sixty-one (86%) patients had associated congenital heart defects (CHDs). Forty-two (59%) patients had pulmonary arterial hypertension (PAH) at the time of diagnosis. Fifty-three (74.7%) patients underwent embolization of the PS feeding vessel using microcoils and/or vascular plugs, and eight (15.1%) of these were neonates who presented with severe PAH and cardiac failure. Two patients had large feeding vessels and were treated surgically. Sixteen (22.5%) patients with small feeding vessels received conservative management. At median follow-up of 36.4 months (IQR, 2.1-89.9), seven patients had died, 24 patients had CHD corrective surgeries, 26 patients had redo catheterizations, and five patients had persistent PAH. No PS surgical resection was needed, and no infection of the remaining lung tissue occurred. CONCLUSIONS Transcatheter assessment and treatment of PSs is a safe and effective procedure. Neonates with large PSs are severely symptomatic and improve remarkably after PS closure. PS embolization and surgical repair of associated CHDs generally leads to the normalization of pulmonary pressures.
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Affiliation(s)
- Ibrahim Abu Zahira
- M3C-Necker, Hôpital Universitaire Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris (AP-HP), 75015 Paris, France
| | - Raymond N Haddad
- M3C-Necker, Hôpital Universitaire Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris (AP-HP), 75015 Paris, France
| | - Mathilde Meot
- M3C-Necker, Hôpital Universitaire Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris (AP-HP), 75015 Paris, France
| | - Damien Bonnet
- M3C-Necker, Hôpital Universitaire Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris (AP-HP), 75015 Paris, France
- Faculté de Médecine, Université de Paris Cité, 15 Rue de l'École de Médecine, 75006 Paris, France
| | - Sophie Malekzadeh-Milani
- M3C-Necker, Hôpital Universitaire Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris (AP-HP), 75015 Paris, France
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3
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Boyle N, Waters DK, McCann J, Butler M, Dodd JD, McCarthy C. Pulmonary Embolus and Hemoptysis Revealing Rare Intralobar Sequestration. Am J Respir Crit Care Med 2023; 207:e4-e5. [PMID: 36174194 DOI: 10.1164/rccm.202206-1196im] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Affiliation(s)
| | - Darragh K Waters
- Department of Radiology, St. Vincent's University Hospital, Dublin 4, Ireland; and
| | - Jeff McCann
- Department of Radiology, St. Vincent's University Hospital, Dublin 4, Ireland; and
| | - Marcus Butler
- Department of Respiratory Medicine and.,School of Medicine, University College Dublin, Dublin 4, Ireland
| | - Jonathan D Dodd
- Department of Radiology, St. Vincent's University Hospital, Dublin 4, Ireland; and.,School of Medicine, University College Dublin, Dublin 4, Ireland
| | - Cormac McCarthy
- Department of Respiratory Medicine and.,School of Medicine, University College Dublin, Dublin 4, Ireland
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4
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Luo D, Fu X, Wang Q, Cheng K, Lv Y, Yuan M, Xu C, He T, Yang G, Wang Y, Jia R, Liu C. Thoracoscopic Clockwise Lobectomy May Be a Stylized Procedure for Treating Children with Congenital Lung Malformations. J Laparoendosc Adv Surg Tech A 2022; 32:1293-1298. [PMID: 36257641 DOI: 10.1089/lap.2022.0078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background: Thoracoscopic lobectomy is a challenging procedure in children with congenital lung malformations (CLMs). This study aims to evaluate the safety and efficacy of thoracoscopic clockwise lobectomy (TCL) in CLMs in children and its potential to be a stylized procedure. Methods: All patients with CLMs who received TCL from 2015 to 2019 in our hospital were retrospectively reviewed. Clinical information was extracted from medical records, including patient demographics, operative details, and outcomes. Results: A total of 184 patients with a median age of 6.8 months (range, 3-156) and a median weight of 9 kg (range, 6-45) received TCL. Lesions were all located in the lower lobe and included congenital pulmonary airway malformation (n = 133), intralobar sequestration (n = 44), bronchiectasis (n = 4), and congenital lobar emphysema (n = 3). The mean (±standard deviation [SD]) operating time was 46 ± 7.5 minutes (range, 35-113). The mean (±SD) blood loss was 3.5 ± 0.8 mL (range, 1-60). Three patients converted to thoracotomy, and 162 patients did not have a chest tube placed. The postoperative course was uneventful in all patients except 2 patients who developed air leaks and 23 patients who developed a mild fever. The median length of postoperative hospital stay was 2 days. A total of 163 patients were followed up for more than 1 year without any complications. Conclusion: TCL is suitable for lower lobectomy and is safe and effective in standard and complicated thoracoscopic lobectomy. It could be recommended as a stylized procedure in treating children with CLMs.
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Affiliation(s)
- Dengke Luo
- Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaoying Fu
- Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Qinghai Wang
- Department of Pediatric Surgery, Guangyuan Central Hospital, Guangyuan, China
| | - Kaisheng Cheng
- Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Yong Lv
- Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Miao Yuan
- Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Chang Xu
- Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Taozhen He
- Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Gang Yang
- Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Yao Wang
- Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Ru Jia
- Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Chenyu Liu
- Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu, China
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5
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El-Ali AM, Strubel NA, Lala SV. Congenital lung lesions: a radiographic pattern approach. Pediatr Radiol 2022; 52:622-636. [PMID: 34716454 DOI: 10.1007/s00247-021-05210-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/29/2021] [Accepted: 09/13/2021] [Indexed: 11/28/2022]
Abstract
Congenital lung malformations represent a spectrum of abnormalities that can overlap in imaging appearance and frequently coexist in the same child. Imaging diagnosis in the neonatal period can be challenging; however, the recognition of several archetypal radiographic patterns can aid in narrowing the differential diagnosis. Major radiographic archetypes include (1) hyperlucent lung, (2) pulmonary cysts, (3) focal opacity and (4) normal radiograph. Here we review the multimodality imaging appearances of the most commonly seen congenital lung malformations, categorized by their primary imaging archetypes. Along with the congenital lung malformations, we present several important imaging mimickers.
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Affiliation(s)
- Alexander Maad El-Ali
- Division of Pediatric Radiology, Department of Radiology, NYU Grossman School of Medicine, 550 First Ave., New York, NY, 10016, USA.
| | - Naomi A Strubel
- Division of Pediatric Radiology, Department of Radiology, NYU Grossman School of Medicine, 550 First Ave., New York, NY, 10016, USA
| | - Shailee V Lala
- Division of Pediatric Radiology, Department of Radiology, NYU Grossman School of Medicine, 550 First Ave., New York, NY, 10016, USA
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6
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Pulido J, Sánchez A, Beltran R, Cruz A, Cabrera F, Hernández M. Secuestro pulmonar con suplencia aberrante del tronco celíaco: reporte de caso. CIRUGIA CARDIOVASCULAR 2020. [DOI: 10.1016/j.circv.2019.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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7
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Kampolis CF, Damaskos C, Loukeri AA, Garmpis N, Garmpi A, Tomos I, Spartalis E, Dimitroulis D, Patsouras A, Douskou M, Papiris SA, Tomos P. Primary Hemangiopericytoma Arising in Extralobar Pulmonary Sequestration: A Coincidence or Two Rare Disorders? In Vivo 2020; 33:2141-2145. [PMID: 31662549 DOI: 10.21873/invivo.11715] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 08/29/2019] [Accepted: 09/03/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND/AIM Extralobar pulmonary sequestration (EPS) is an unusual congenital defect characterized by the presence of non-functioning lung tissue receiving arterial supply from the systemic arteries. Primary hemangiopericytoma (HPC) is an uncommon potentially malignant tumor of vascular origin that usually involves the soft tissue of the extremities or retroperitoneum, but extremely rarely affects the lung. We present the rare case of a primary pulmonary HPC arising in an EPS. CASE REPORT A 65-year-old woman, with dyspnea and pleuritic chest pain, was referred for further investigation. Radiological evaluation demonstrated a well-circumscribed mass above the right hemidiaphragm, receiving its arterial supply from the descending thoracic aorta. The patient underwent a right posterolateral thoracotomy and a middle lobectomy. The intraoperative finding was a well-encapsulated solid mass. The histological evaluation described HPC. RESULTS The patient remains fit and healthy. CONCLUSION Pulmonary HPC can arise in EPS. Surgical excision is the treatment of choice.
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Affiliation(s)
- Christos F Kampolis
- Department of Pathophysiology, University of Athens, Medical School, Athens, Greece
| | - Christos Damaskos
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Angeliki A Loukeri
- Respiratory Care Unit, Sotiria Hospital, General Hospital of Chest Diseases, Athens, Greece
| | - Nikolaos Garmpis
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Anna Garmpi
- First Department of Propedeutic Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis Tomos
- Second Pulmonary Medicine Department, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Eleftherios Spartalis
- N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Dimitroulis
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | | | - Spyros A Papiris
- Second Pulmonary Medicine Department, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Periklis Tomos
- Department of Thoracic Surgery, Attikon University Hospital, Athens Medical School, National and Kapodistrian University of Athens, Chaidari, Greece
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8
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Robson VK, Shieh HF, Wilson JM, Buchmiller TL. Non-operative management of extralobar pulmonary sequestration: a safe alternative to resection? Pediatr Surg Int 2020; 36:325-331. [PMID: 31707604 DOI: 10.1007/s00383-019-04590-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/13/2019] [Indexed: 12/17/2022]
Abstract
PURPOSE This retrospective cohort study compares the natural history of patients with extralobar sequestrations (ELS) who do not undergo intervention with those who undergo resection to assess the safety of non-operative management. METHODS 126 patients with pulmonary sequestrations or congenital pulmonary airway malformations born between 1999 and 2016 were identified. 49 patients had ELS on postnatal imaging, but two were excluded for associated congenital diaphragmatic hernia. Demographic and clinical data were retrospectively reviewed, with phone follow-up for non-operative patients with no records for > 1 year. Statistical analysis was by Fisher's exact test or Wilcoxon signed-rank test (two-tailed p < 0.05). RESULTS 40% (19/47) were managed non-operatively and 60% (28/47) underwent resection. Non-operative patients were less likely to have an intrathoracic ELS: 47% (9/19) vs. 75% (21/28), p = 0.07. No symptoms were attributable directly to the ELS. Non-operative patients had median follow-up 3.2 years, during which time 88% (15/17) of ELS decreased in size on serial imaging. For patients who underwent resection, there was 100% concordance between imaging and intraoperative findings. There was no evidence of inflammation, infection or malignancy on final pathology, though 57% (16/28) of resected lesions had foci of non-aerated cysts. CONCLUSIONS Although further longitudinal study is required, this study supports the safety of non-operative ELS management.
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Affiliation(s)
- Victoria K Robson
- Department of Medicine and Pediatrics, Boston Children's Hospital and Harvard Medical School, Boston, MA, 02115, USA
| | - Hester F Shieh
- Department of Surgery, Boston Children's Hospital and Harvard Medical School, 300 Longwood Avenue, Fegan 3rd Floor, Boston, MA, 02115, USA
| | - Jay M Wilson
- Department of Surgery, Boston Children's Hospital and Harvard Medical School, 300 Longwood Avenue, Fegan 3rd Floor, Boston, MA, 02115, USA
| | - Terry L Buchmiller
- Department of Surgery, Boston Children's Hospital and Harvard Medical School, 300 Longwood Avenue, Fegan 3rd Floor, Boston, MA, 02115, USA.
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9
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Traibi A, Seguin-Givelet A, Brian E, Grigoroiu M, Gossot D. [Pulmonary intralobar sequestration in adults: Evolution of surgical treatment]. Rev Mal Respir 2019; 36:129-134. [PMID: 30686557 DOI: 10.1016/j.rmr.2018.10.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 03/04/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Until now, the traditional procedure to treat intralobar pulmonary sequestration (ILS) in adults has been a lobectomy performed by open thoracotomy. We have reviewed our data to observe if the surgical management of these lesions has evolved over the last years. METHODS We retrospectively reviewed the records of the patients who were operated for an ILS either by posterolateral thoracotomy (PLT group), or by thoracoscopy (TS group) between 2000 and 2016. RESULTS Eighteen patients were operated for a SIL during this period. Prior to 2011, all resections were performed by thoracotomy (n=6) and after 2011 the surgical approach was either a thoracotomy (n=5) or a thoracoscopy (n=7). There was one conversion because of dense pleural adhesions and this patient was integrated in the PLT group for further analysis. ILS were more frequently encountered on the left side (n=12, 66.6 %) than on the right one (n=6, 33.3 %) and exclusively in the lower lobes. All patients of the PLT group underwent a lobectomy. In the TS group, 5 patients underwent a sublobar resection (2 segmentectomiesS9+10, 1 basilar segmentectomy and 2 atypical resections). There was no mortality. In the PLT group, 5 patients (45 %) had complications versus one patient (14 %) in the TS group. The mean hospital stay was 7.4 days in the PLT group versus 5.4 days in the TS group. CONCLUSIONS These data confirm that ILS can be safely treated by a sublobar resection that should be performed, whenever possible, thoracoscopically.
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Affiliation(s)
- A Traibi
- Département thoracique, institut mutualiste Montsouris, institut du thorax Curie-Montsouris, 42, boulevard Jourdan, 75014 Paris, France
| | - A Seguin-Givelet
- Département thoracique, institut mutualiste Montsouris, institut du thorax Curie-Montsouris, 42, boulevard Jourdan, 75014 Paris, France; UFR SMBH, université Sorbonne Paris Cité, université Paris 13, 93000 Paris, France
| | - E Brian
- Département thoracique, institut mutualiste Montsouris, institut du thorax Curie-Montsouris, 42, boulevard Jourdan, 75014 Paris, France
| | - M Grigoroiu
- Département thoracique, institut mutualiste Montsouris, institut du thorax Curie-Montsouris, 42, boulevard Jourdan, 75014 Paris, France
| | - D Gossot
- Département thoracique, institut mutualiste Montsouris, institut du thorax Curie-Montsouris, 42, boulevard Jourdan, 75014 Paris, France.
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10
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Annunziata F, Bush A, Borgia F, Raimondi F, Montella S, Poeta M, Borrelli M, Santamaria F. Congenital Lung Malformations: Unresolved Issues and Unanswered Questions. Front Pediatr 2019; 7:239. [PMID: 31249823 PMCID: PMC6584787 DOI: 10.3389/fped.2019.00239] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 05/28/2019] [Indexed: 12/30/2022] Open
Abstract
Advances in prenatal and postnatal diagnosis, perioperative management, and postoperative care have dramatically increased the number of scientific reports on congenital thoracic malformations (CTM). Nearly all CTM are detected prior to birth, generally by antenatal ultrasound. After delivery, most infants do well and remain asymptomatic for a long time. However, complications may occur beyond infancy, including in adolescence and adulthood. Prenatal diagnosis is sometimes missed and detection may occur later, either by chance or because of unexplained recurrent or persistent respiratory symptoms or signs, with difficult implications for family counseling and substantial delay in surgical planning. Although landmark studies have been published, postnatal management of asymptomatic children is still controversial and needs a resolution. Our aim is to provide a focused overview on a number of unresolved issues arising from the lack of an evidence-based consensus on the management of patients with CTM. We summarized findings from current literature, with a particular emphasis on the vigorous controversies on the type and timing of diagnostic procedures, treatments and the still obscure relationship between CTM and malignancies, a matter of great concern for both families and physicians. We also present an algorithm for the assessment and follow-up of CTM detected either in the antenatal or postnatal period. A standardized approach across Europe, based on a multidisciplinary team, is urgently needed for achieving an evidence-based management protocol for CTM.
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Affiliation(s)
- Federica Annunziata
- Division of Paediatrics, Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Andrew Bush
- Department of Paediatrics and Paediatric Respiratory Medicine, Imperial College and Royal Brompton Hospital, London, United Kingdom
| | - Francesco Borgia
- Divisions of Cardiology and Cardiothoracic Surgery, Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | - Francesco Raimondi
- Division of Paediatrics, Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Silvia Montella
- Division of Paediatrics, Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Marco Poeta
- Division of Paediatrics, Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Melissa Borrelli
- Division of Paediatrics, Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Francesca Santamaria
- Division of Paediatrics, Department of Translational Medical Sciences, Federico II University, Naples, Italy
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11
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Kamal YA, Mubarak YS. Pulmonary sequestration mimicking lung abscess in old age. ANZ J Surg 2018; 89:E462-E463. [PMID: 30117665 DOI: 10.1111/ans.14759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 05/17/2018] [Accepted: 05/30/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Yasser A Kamal
- Department of Cardiothoracic Surgery, Minia University Hospital, El-Minia, Egypt
| | - Yasser S Mubarak
- Department of Cardiothoracic Surgery, Minia University Hospital, El-Minia, Egypt
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12
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Traibi A, Seguin-Givelet A, Brian E, Grigoroiu M, Gossot D. Adult pulmonary intralobar sequestrations: changes in the surgical management. J Vis Surg 2018; 4:62. [PMID: 29682472 DOI: 10.21037/jovs.2018.02.13] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 02/09/2018] [Indexed: 11/06/2022]
Abstract
Background Until now, the traditional procedure to treat intralobar pulmonary sequestration (ILS) in adults has been a lobectomy performed by open chest surgery. We have reviewed our data to determine whether the surgical management of these lesions has evolved over the last years. Methods We retrospectively reviewed the records of patients who were operated on for an ILS by either posterolateral thoracotomy (PLT group), or by thoracoscopy (TS group) between 2000 and 2016. Results Eighteen patients were operated on for a ILS during this period. Before 2011, all resections were performed by thoracotomy (n=6) and after 2011 the approach was either a thoracotomy (n=5) or a thoracoscopy (n=7). There was one conversion because of dense pleural adhesions and this patient was integrated in the PLT group for further analysis. ILS presented more frequently on the left side (n=12, 66.7%) than on the right one (n=6, 33.3%) and exclusively in the lower lobes. All the PLT group patients underwent a lobectomy. In the TS group, five patients underwent a sublobar resection (2 segmentectomies S9+10, 1 basilar segmentectomy and 2 atypical resections). There was no mortality. In the PLT group, 5 patients (45%) had complications versus one patient (14%) in the TS group. The mean hospital stay was 7.4 days in the PLT group versus 5.4 days in the TS group. Conclusions These data confirm that ILS can be safely treated by a sublobar resection that should be performed, whenever possible, without opening the chest.
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Affiliation(s)
- Akram Traibi
- Thoracic Department, Institut du Thorax Curie-Montsouris, Institut Mutualiste Montsouris, Paris, France
| | - Agathe Seguin-Givelet
- Thoracic Department, Institut du Thorax Curie-Montsouris, Institut Mutualiste Montsouris, Paris, France.,Paris 13 University, Sorbonne Paris Cité, Faculty of Medicine SMBH, Bobigny, France
| | - Emmanuel Brian
- Thoracic Department, Institut du Thorax Curie-Montsouris, Institut Mutualiste Montsouris, Paris, France
| | - Madalina Grigoroiu
- Thoracic Department, Institut du Thorax Curie-Montsouris, Institut Mutualiste Montsouris, Paris, France
| | - Dominique Gossot
- Thoracic Department, Institut du Thorax Curie-Montsouris, Institut Mutualiste Montsouris, Paris, France
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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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14
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Abstract
Bronchopulmonary sequestration (BPS) is a lung mass that does not communicate with the tracheobronchial tree or the pulmonary arterial vasculature, and thus does not play a role in oxygenation. This article discusses the etiology of BPS, as well as its pathophysiology, signs and symptoms, imaging studies used to diagnose, and treatment options in both pediatric and adult patients.
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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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Ríos-Méndez RE, Andrade-Herrera JN, Araúz-Martínez ME. Resultados a corto plazo del tratamiento percutáneo de secuestro pulmonar en hospital pediátrico ubicado en la región andina: serie de casos. Arch Bronconeumol 2017; 53:163-164. [DOI: 10.1016/j.arbres.2016.06.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 06/21/2016] [Accepted: 06/21/2016] [Indexed: 11/28/2022]
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Mattioli G, Pio L, Disma NM, Torre M, Sacco O, Pistorio A, Zanaboni C, Montobbio G, Barra F, Ramenghi LA. Congenital Lung Malformations: Shifting from Open to Thoracoscopic Surgery. Pediatr Neonatol 2016; 57:463-466. [PMID: 27036100 DOI: 10.1016/j.pedneo.2015.10.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 10/01/2015] [Accepted: 10/29/2015] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND Over the years the need for surgical treatment, timing of intervention, and the type of surgical approach have been discussed, but the treatment of congenital lung malformations remains controversial. The aim of this study was to compare the thoracotomy approach with the thoracoscopic technique by evaluating different surgical outcomes (duration of surgery, postoperative hospital stay, and complications). METHODS All patients operated from January 2011 to March 2015 for suspected congenital cystic lung were included in the study. Patients treated for congenital lobar emphysema and tracheobronchial neoplasms were excluded from the study. RESULTS In the analyzed period, 31 asymptomatic patients were treated: 18 lung resections were performed with thoracotomy (Group A) and 13 with the thoracoscopic approach (Group B). No significant differences were observed between the age and weight at surgery, length of the procedures, complications, and the need for postoperative intensive care between the two groups. The postoperative hospital stay in Group A was twice that for Group 2 (p = 0.0009). CONCLUSION Comparing thoracoscopic surgery with the traditional open approach, we confirmed the superiority of minimally invasive treatment in terms of postoperative hospital stay. Common technical recommendations can help pediatric centers to develop the thoracoscopic approach for the treatment of congenital pulmonary malformations.
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Affiliation(s)
- Girolamo Mattioli
- Pediatric Surgery Unit, Istituto Giannina Gaslini, Genoa, Italy; DINOGMI, University of Genoa, Genoa, Italy
| | - Luca Pio
- Pediatric Surgery Unit, Istituto Giannina Gaslini, Genoa, Italy; DINOGMI, University of Genoa, Genoa, Italy.
| | | | - Michele Torre
- Pediatric Surgery Unit, Istituto Giannina Gaslini, Genoa, Italy
| | - Oliviero Sacco
- Pediatric Pulmonology Unit, Istituto Giannina Gaslini, Genoa, Italy
| | - Angela Pistorio
- Epidemiology and Biostatistics Service, Istituto Giannina Gaslini, Genoa, Italy
| | - Clelia Zanaboni
- Pediatric Anesthesia Unit, Istituto Giannina Gaslini, Genoa, Italy
| | | | - Fabio Barra
- Pediatric Surgery Unit, Istituto Giannina Gaslini, Genoa, Italy
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Truant AS, Eucher P, Trigaux JP, Weynand B, Bodart E. Hémoptysies récidivantes chez un adolescent : à propos d’un cas de séquestration bronchopulmonaire. Arch Pediatr 2014. [DOI: 10.1016/j.arcped.2014.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Adenocarcinoma arising in an extralobar sequestration: a case report and review of the literature. Lung Cancer 2014; 84:92-5. [DOI: 10.1016/j.lungcan.2014.01.025] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Revised: 12/17/2013] [Accepted: 01/27/2014] [Indexed: 01/09/2023]
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