GULHANE MEDICAL JOURNAL 2019 , Vol 61 , Issue 2
Pulmonary sequestrations: Experience of 31 patients
Ersin Sapmaz1,Merve Şengül İnan1,Hakan Işık1,Okan Karataş2,Hasan Çaylak1,Sedat Gürkök1
1Gulhane Training and Research Hospital, Department of Thoracic Surgery, Ankara, Turkey
2Sinop Atatürk State Hospital, Department of Thoracic Surgery, Sinop, Turkey
DOI : 10.26657/gulhane.00058 Aims: Pulmonary sequestration (PS) is a rare congenital lung malformation. It is characterized by a nonfunctional pulmonary tissue that have no relation to the bronchial system. Case series are rare due to low incidence of pulmonary sequestration. In this study, we aim to analyze the presentation, demographics, diagnostic procedures, location, type and treatment of PS in our institution over 12-year period.

Methods: We retrospectively evaluated medical records of pathologically proved PS from January 2003 through December 2015 in our institution. Thirty-one patients were included in the study. Demographics, clinical presentation, diagnostic imaging, location, type of sequestration, type of surgery were collected.

Results: Of 31 patients, 3 patients (9.6%) were female and 28 patients were (90.3%) male. Average age was 24.6 years. Twenty-four (77%) patients had described symptoms. Chest X-ray scanning was performed to all patients as the first imaging modality. Of the 15 patients (48.4%) had intralobar sequestration and 16 patients (51.6%) had extralobar sequestration. Extralobar sequestrations were more common (55.1%). Lower lobectomy in 13 patients, segmentectomy in 2 intralobar sequestration patients, and simple mass excision in all extralobar sequestration patients (16 patients) were performed as surgical procedure. Six patients had postoperative complications: prolonged air leak in 4 patients, pneumonia in 2 patients.

Conclusions: It has similar appearance with many diseases of lung with traditional imaging methods and cause difficulties in diagnosis. Proving the presence of a feeding systemic artery with angiographic imaging is essential for definitive diagnosis. The recommended optimal treatment for pulmonary sequestration is resection of the sequestered tissue by segment or lobar resection. Keywords : Pulmonary sequestration, extralobar sequestration, intralobar sequestration, pulmonary congenital malformation, thoracic surgery