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[Pulmonary sequestration. Surgical aspects based on 61 cases].

A Sauvanet1, J F Regnard, F Calanducci

  • 1Hôpital Marie Lannelongue, Le Plessis Robinson.

Revue De Pneumologie Clinique
|January 1, 1991
PubMed
Summary
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Surgical intervention for lung sequestration, a congenital anomaly involving abnormal lung tissue, is effective. Arteriography is crucial for diagnosis and surgical planning, with surgery indicated for symptomatic cases or diagnostic uncertainty.

Area of Science:

  • Cardiothoracic Surgery
  • Pediatric Surgery
  • Diagnostic Imaging

Background:

  • Lung sequestration is a rare congenital lung malformation.
  • It can present with recurrent respiratory infections or be asymptomatic.
  • Accurate diagnosis and surgical planning are essential for optimal outcomes.

Purpose of the Study:

  • To review surgical outcomes for lung sequestration.
  • To evaluate diagnostic methods for lung sequestration.
  • To determine the optimal surgical approach for different types of lung sequestration.

Main Methods:

  • Retrospective review of 61 patients operated for lung sequestration between 1955 and 1989.
  • Analysis of clinical presentation, diagnostic imaging (including chest X-ray, arteriography, CT, MRI), surgical procedures, and outcomes.

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  • Classification of sequestration into intralobar and extralobar types.

    • Main Results:

    • 61 patients (33 men, 28 women; mean age 20 years) underwent surgery.
    • Intralobar sequestration occurred in 49 cases, extralobar in 10, and both in 2.
    • Recurrent bronchopneumonia was the most common symptom (54%).
    • Arteriography identified abnormal systemic arteries in 28 of 40 patients.
    • Surgical complications occurred in 5 cases (3.3%); operative mortality was 0%, morbidity 5%.
    • Arteriography was deemed the best method for diagnosis and surgical guidance.

    Conclusions:

    • Surgery is the definitive treatment for symptomatic or diagnostically uncertain lung sequestration.
    • Arteriography plays a vital role in preoperative assessment and surgical planning.
    • Modern imaging like CT and MRI can aid diagnosis but arteriography remains key for vascular assessment.