Surgical treatment for pulmonary sequestration

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  • 肺分画症に対する外科治療１５例の検討

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We reviewed 15 patients with pulmonary sequestration. Between 1994 and 2010, 15 patients (five males and 10 females, mean age of 27. 2 years old) with pulmonary sequestration were surgically treated at either of two hospitals. Clinical symptoms such as cough, fever, and hemoptysis led to a diagnosis in 13 patients, and the remaining two were incidentally diagnosed on radiograph as part of a health check. Preoperatively, aberrant arteries were identified by contrast-enhanced computed tomography (CT) in 11 cases, but not in 4 cases. Lung lobectomy was performed in 12 patients, segmentectomy in two, and resection of an extrapleural lesion in one; in 11 patients through open thoracotomy and in four using video-assisted thoracic surgery (VATS). In two of the four patients undergoing VATS, the surgical approach was converted from VATS to open thoracotomy because of thick adhesions or a large aberrant artery. Aberrant arteries were successfully occluded with a stapling device in eight patients, ligation-and-resection in six, and suturing in one case of a large aberrant artery. There was no morbidity and no mortality. In conclusion, three-dimensional CT is useful for detecting an aberrant artery in pulmonary sequestration cases, and a stapling device can be used for dividing the aberrant artery.

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