Surgical treatment of intralobar pulmonary sequestration

Objective To evaluate the clinical features, diagnosis, treatment, and outcome of intralobar pulmonary sequestration (ILS). Methods Patients who were diagnosed with ILS in our hospital between January 1988 and January 2009 were retrospectively reviewed. We recorded the clinical symptoms, imaging findings, operative technique, complications, and outcome of these patients. Results Forty-seven patients (25 men and 22 women) with an average age of 32.3 years were enrolled. Forty-two patients had symptoms including cough and hemoptysis. Chest X-ray, computed tomography (CT), magnetic resonance imaging (MRI), and angiography were performed. Thoracotomy was performed in 45 patients, while thoracoscopy was performed in 2 patients. Lobectomy was the most common treatment procedure. Massive bleeding developed in 2 patients due to injury of aberrant supplying artery intraoperatively, 1 patient had atrial fibrillation, 1 patient had thrombosis of upper extremity postoperatively. All patients were confirmed the diagnosis pathologically, 4 accompanied with bronchogenic cyst, 15 with bronchiectasis, 8 with infection, 2 with aspergilloma, and 1 with carcinoid. No late complications occurred. Conclusions ILS is rare, surgery is recommended because some patients may have potential severe complications. Contrast enhanced CT and three-dimensional reconstruction is the best diagnostic method. Both thoracotomy and thoracoscopy are appropriate for the selected candidates.