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Pulmonary sequestration: 17-year experience at UCLA

H W Louie1, S M Martin, D G Mulder

  • 1Department of Surgery, UCLA School of Medicine 90024-1741.

The American Surgeon
|December 1, 1993
PubMed
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Pulmonary sequestration, a rare lung anomaly, was treated in 10 patients. Surgical resection via thoracotomy resulted in excellent outcomes for most, highlighting the importance of accurate diagnosis and surgical expertise.

Area of Science:

  • Thoracic Surgery
  • Pediatric Surgery
  • Diagnostic Imaging

Background:

  • Pulmonary sequestration is a congenital lung malformation characterized by abnormal lung tissue with anomalous vasculature.
  • This condition can present with diverse symptoms, including recurrent pneumonia and respiratory distress, affecting both pediatric and adult populations.
  • Accurate diagnosis is crucial for effective management and surgical planning.

Purpose of the Study:

  • To review the clinical presentation, diagnostic methods, and surgical outcomes of pulmonary sequestration cases treated at a single institution.
  • To evaluate the efficacy of various imaging modalities in diagnosing pulmonary sequestration.
  • To emphasize the importance of surgical intervention for this anomaly.

Main Methods:

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  • Retrospective review of 10 patients diagnosed with pulmonary sequestration between 1975 and 1992.
  • Analysis of clinical data, including age, sex, symptoms, and presenting conditions.
  • Evaluation of diagnostic imaging results (chest radiography, computed tomography, angiography, ultrasonography, MRI) and surgical findings.

    • Main Results:

    • Ten patients (7 female, 3 male) with intralobar and extralobar pulmonary sequestration were treated.
    • Symptoms varied, with recurrent pneumonia and respiratory distress being most common.
    • All patients underwent successful thoracotomy and lobectomy with no operative mortality; nine had excellent long-term outcomes.
    • Chest radiography and CT scans were the most informative imaging modalities.

    Conclusions:

    • Pulmonary sequestration is an uncommon but treatable condition.
    • Surgical resection through thoracotomy offers excellent results for patients with pulmonary sequestration.
    • Awareness of anomalous vascular connections is vital for successful surgical management by thoracic surgeons.