Current Thoracic Surgery 2016 , Vol 1 , Issue 1
Pulmonary sequestration: is it fraught to operate without the diagnosis?
A. Cevat Kutluk1,Celalettin İ. Kocatürk1,Hasan Akın1,M. Ali Bedirhan1,Altan Ceritoğlu1,Merve Hatipoğlu1,Kemal Karapınar1,Özkan Saydam1
1Department of Thoracic Surgery, Yedikule Chest Diseases and Thoracic Surgery Education and Research Hospital, Istanbul, Turkey. DOI : 10.26663/cts.2016.0004 Background: Pulmonary sequestration is defined as nonfunctional lung tissue without a normal tracheobronchial tree that is supplied by an aberrant systemic artery. The awareness of the preoperative diagnosis could be very crucial for the safety of the operation.

Materials and Methods: We retrospectively reviewed the records of 16 patients who underwent resection for pulmonary sequestration between 2006-2016. Nine of 16 cases (56%) were female, and the mean age of the patients was 38.5 ± 9.9 years. Fiberoptic bronchoscopy and standard computed thorax tomography were performed for diagnostic work-up in all cases. The patients were divided into 2 groups based on the presence (Group A) or abscence (Group B) of the preoperative diagnosis.

Results: The most common presenting symptoms were cough and expectoration. Preoperative diagnosis of the sequestration was obtained in only 5 patients (31%). Bronchiectasis was the most common cause of false diagnosis, followed by hydatid disease, malignancy, and aspergillosis. Left-sided and intrapulmonary locations were dominant with 12 (75%) and 13 (81%) cases, respectively. Lobectomy was the most common type of surgical resection (75%) and thoracic aorta was the source of aberrant artery in 87% of the patients. Patients in group A were younger. Though intralobar and extralobar types were equally distributed in both groups, all cases in group B had intralobar type. The mean operation time, blood loss, the amount of drainage, and the hospital stay were all insignificantly longer in group B patients. Five of the 6 morbidities occured in group B patients, but the difference was not statistically significant. No mortality occured.

Conclusions: Surgical resection provides definitive management, and is usually reserved for the patients with symptoms. Facilities for a definitive diagnosis should be performed in every case, because, although insignificant, the rate of morbidity is higher in the patients without a definitive diagnosis. Further studies concerning of more patients are required to obtain more comprehensive results. Keywords : Pulmonary sequestration; lobectomy; diagnosis; bronchiectasis