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. 2021 Jul;56(7):2322-2327.
doi: 10.1002/ppul.25433. Epub 2021 Apr 30.

The clinical management of extralobar pulmonary sequestration in children

Dongmei Huang  1 , Aerxin Habuding  2 , Miao Yuan  3 , Gang Yang  3 , Kaisheng Cheng  3 , Dengke Luo  3 , Chang Xu  3
Affiliations

The clinical management of extralobar pulmonary sequestration in children

Dongmei Huang et al. Pediatr Pulmonol. 2021 Jul.

Abstract

Introduction: The treatment of extralobar pulmonary sequestration (ELS) remains divergent. This study aims to demonstrate the characters of ELS in children for optimal clinical management in the future.

Material and methods: A retrospective analysis was conducted for ELS patients' treatment in our center from January 2013 to April 2020.

Results: In total, 85 patients were included, containing 70 upper-diaphragmatic, 7 intra-diaphragmatic, and 8 infra-diaphragmatic ELS. Eight patients' pathology results showing inflammation without symptoms preoperation and two patients had chest pain for torsion. All the upper-diaphragmatic and intra-diaphragmatic ELS patients accepted thoracoscopic surgery resection. The intraoperative operation time and blood loss volume of intra-diaphragmatic ELS were significantly more than that of the upper-diaphragmatic (40.14 ± 9.92 vs. 23.07 ± 6.79 min; 9.29 ± 3.45 vs. 3.18 ± 4.94 ml; all p < .05). No chest tubes were inserted in both subgroups. No complications were found in the postoperative follow-up of operative ELS patients at least 3 months. A total of eight infra-diaphragmatic ELS patients except for one (7/8) had conservative therapy and follow-up by the outpatient clinic or phone call eventually. There were no symptoms occurring and no size increasing of observation infra-diaphragmatic ELS.

Conclusions: The ELS has the potential risk of infection and torsion in this study. Thoracoscopic surgery might be optimal management of upper-diaphragmatic ELS for its minimal invasion and low perioperative risks, which could be developed into a day operation with safe and quick recovery. The intra-diaphragmatic and infra-diaphragmatic ELS need a larger sample size and multiple center data to get a better management approach.

Keywords: clinical management; extralobar pulmonary sequestration; thoracoscopic surgery.

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References

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