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Introduction <p>Pulmonary sequestration (PS) is an uncommon lesion in the pediatric population. Once diagnosed, surgical excision is the treatment of choice, even if the lesion is asymptomatic. The thoracoscopic approach has the advantage of delicately handling the direct aortic vessel. Here, we discuss the presentation and management of PS that underwent thoracoscopic excision (TE) and review relevant literature.</p> Patients and methods <p>The study included children diagnosed with PS who underwent TE. The main mode of diagnosis was CECT chest with angiogram. The TE technique stressed early ligation of the arterial vessel before clipping any draining pulmonary vein to prevent congestion of the lesion.</p> Results <p>Five patients (all females) aged between 9&#xa0;months and 9&#xa0;years were operated on. Three patients had recurrent respiratory infections, and two were antenatally diagnosed. The smallest patient was antenatally diagnosed and was followed after birth. The biggest girl had presented with a recurrent respiratory infection and had a cavitary lesion in the sequestered segment. CECT in all patients showed systemic blood supply from the aorta or celiac trunk. Extra-lobar sequestration was present in three patients, and two children had intra-lobar sequestration. All five patients had undergone successful TE and were discharged on the 4th day (average) after surgery. During follow-up, all five girls were doing well.</p> Conclusion <p>Thoracoscopic excision for PS is a safe procedure. Success depends on documenting the precise arterial anatomy of the lesion and tackling it intraoperatively using the artery-first approach.</p>

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Thoracoscopic excision of pulmonary sequestration in children: tackling the intra-lobar and extra-lobar lesions

  • 期刊论文

  • 发表日期：

    2025年3月5日

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  • Shailesh Solanki,
  • Ravi Prakash Kanojia,
  • Nitin James Peters,
  • Sravanthi Vutukuru,
  • Jai Kumar Mahajan

摘要

Introduction

Pulmonary sequestration (PS) is an uncommon lesion in the pediatric population. Once diagnosed, surgical excision is the treatment of choice, even if the lesion is asymptomatic. The thoracoscopic approach has the advantage of delicately handling the direct aortic vessel. Here, we discuss the presentation and management of PS that underwent thoracoscopic excision (TE) and review relevant literature.

Patients and methods

The study included children diagnosed with PS who underwent TE. The main mode of diagnosis was CECT chest with angiogram. The TE technique stressed early ligation of the arterial vessel before clipping any draining pulmonary vein to prevent congestion of the lesion.

Results

Five patients (all females) aged between 9 months and 9 years were operated on. Three patients had recurrent respiratory infections, and two were antenatally diagnosed. The smallest patient was antenatally diagnosed and was followed after birth. The biggest girl had presented with a recurrent respiratory infection and had a cavitary lesion in the sequestered segment. CECT in all patients showed systemic blood supply from the aorta or celiac trunk. Extra-lobar sequestration was present in three patients, and two children had intra-lobar sequestration. All five patients had undergone successful TE and were discharged on the 4th day (average) after surgery. During follow-up, all five girls were doing well.

Conclusion

Thoracoscopic excision for PS is a safe procedure. Success depends on documenting the precise arterial anatomy of the lesion and tackling it intraoperatively using the artery-first approach.