The diagnosis and surgical management of pulmonary sequestration in adults: a case series from a single centre in the UK.

Pub Date : 2024-01-01 Epub Date: 2023-09-04 DOI:10.1007/s12055-023-01589-2
Ashar Asif, Daniel Lilley, Sherene Howard-Walker, Shereen Ajab, Syed Suhail Qadri
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Abstract

Pulmonary sequestration (PS) is a rare congenital malformation where extrapulmonary lung tissue receives systemic blood supply from an anomalous branch directly from the thoracic or abdominal aorta. Whilst non-malignant, it can often present with similar symptoms as lung cancer. We present a retrospective review of 8 consecutive adult patients undergoing surgical management for PS within a single centre in the UK. Of our cohort, 62.5% had never smoked. PS in the right lung was seen in 62.5% of cases. Anomalous branches of the pulmonary artery, pulmonary vein or coeliac axis supplied 37.5% of the PS seen in our cohort, and 12.5% did not have a radiologically identifiable blood supply. Techniques varied from thoracotomy (n = 4), video-assisted thoracoscopic surgery (VATS) (n = 3) to robotic resection (n = 1) with no intra-operative or post-operative complications reported within hospital. The mean length of stay was 2 days. The post-operative mortality rate was 12.5%; one patient had died following the robotic resection of the mass of pneumonia in the local district hospital 26 days post-operatively after being discharged. No other complications nor recurrence was recorded over the follow-up period. Where pulmonary masses receive blood supply from anomalous branches of the pulmonary vein and coeliac axis, diagnoses of PS should be considered. The clinical feasibility of discharge in 2 days with no symptom recurrence should undergo further investigation with a larger sample size.

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成人肺隔离症的诊断和外科治疗:来自英国一个中心的一系列病例
肺动脉栓塞(PS)是一种罕见的先天性畸形,肺外的肺组织直接从胸主动脉或腹主动脉的异常分支获得全身血液供应。虽然不是恶性肿瘤,但其症状往往与肺癌相似。我们对英国一家中心连续接受 PS 手术治疗的 8 名成年患者进行了回顾性研究。在我们的病例中,62.5%的患者从未吸烟。62.5%的病例PS位于右肺。37.5%的PS由肺动脉、肺静脉或腹腔轴的异常分支供应,12.5%的PS没有放射学上可识别的血液供应。手术技术多种多样,包括开胸手术(4 例)、视频辅助胸腔镜手术(VATS)(3 例)和机器人切除术(1 例),医院内未报告术中或术后并发症。平均住院时间为 2 天。术后死亡率为12.5%;一名患者在机器人切除肿块后因肺炎于术后26天出院,在当地地区医院死亡。在随访期间,没有其他并发症或复发的记录。当肺部肿块接受肺静脉和腹腔轴异常分支的血液供应时,应考虑 PS 的诊断。2 天内出院且无症状复发的临床可行性应在样本量更大的情况下进一步研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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