Video-assisted thoracic surgery for pulmonary sequestration: a safe alternative procedure

Area of Science:

• Thoracic Surgery
• Congenital Anomalies
• Minimally Invasive Surgery

Background:

• Pulmonary sequestration (PS) is a rare congenital lung anomaly typically treated with conventional thoracotomy.
• The efficacy and safety of video-assisted thoracic surgery (VATS) for PS have not been extensively studied.

Purpose of the Study:

• To evaluate the efficacy and safety of VATS in treating pulmonary sequestration.
• To compare VATS outcomes with conventional thoracotomy in a large Chinese cohort.

Main Methods:

• Retrospective review of 58 patients with PS who underwent surgical resection (2003-2014).
• 42 patients underwent thoracotomy, and 16 underwent attempted VATS resection.
• Data collected included patient demographics, sequestration characteristics, surgical approach, operative details, and complications.

Main Results:

• No significant differences in operative time, hospital stay, or complications between VATS and thoracotomy.
• VATS group experienced less blood loss but longer chest tube duration and greater drainage volume.
• Conversion to thoracotomy occurred in 18.8% of VATS cases due to adhesions or bleeding.

Conclusions:

• VATS is a viable alternative for PS treatment in select patients.
• Simple PS without adhesions is a good indication for VATS anatomic lobectomy.
• Thoracic cavity and hilum adhesions present challenges for VATS.