Intra-diaphragmatic extralobar pulmonary sequestration: Surgical approaches and outcome.

Area of Science:

• Pediatric Surgery
• Congenital Lung Malformations
• Thoracic Surgery

Background:

• Intra-diaphragmatic extralobar pulmonary sequestration (IDEPS) is an extremely rare congenital lung malformation.
• Management strategies for IDEPS are controversial due to localization difficulties and limited case series.

Purpose of the Study:

• To analyze the treatment experience of IDEPS across multiple centers.
• To compare findings with existing literature on pediatric IDEPS.

Main Methods:

• Retrospective multicenter study of pediatric patients treated for IDEPS (2010-2024).
• Data collected from hospital records including demographics, surgical approach, operative time, complications, and recovery.
• Literature review conducted to identify relevant pediatric IDEPS studies.

Main Results:

• Twenty-three patients (24 IDEPS) were analyzed; median age at surgery was 8.2 months.
• Minimally invasive approaches (thoracoscopy, laparoscopy) were utilized in 19 patients, with low conversion rates.
• Median operative time was 157 minutes, median hospital stay was 4.5 days, and postoperative complications occurred in 4.3% of patients.

Conclusions:

• Surgical resection is the primary treatment for IDEPS, with minimally invasive techniques showing efficacy.
• Accurate preoperative imaging and prompt intervention are crucial for successful outcomes, especially with hybrid lesions.
• Standardized management guidelines for IDEPS are needed.