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      Port-Access Thoracoscopic Anatomical Segmentectomy for Pediatric Intralobar Pulmonary Sequestration

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          Abstract

          This report describes successful port-access thoracoscopic anatomical left lateral and posterior basal (S9 + 10) lung segmentectomy performed for intralobar pulmonary sequestration (ILPS) in a 5-year-old girl with recurrent pneumonia. Computed tomography revealed a multilocular lung abscess and an anomalous artery arising from the left gastric artery supplying the affected segment. After diagnosing ILPS, we performed thoracoscopic anatomical S9 + 10 segmentectomy. We consider thoracoscopic lung segmentectomy to be an important therapeutic option for pediatric ILPS.

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          Anatomic thoracoscopic pulmonary segmentectomy under 3-dimensional multidetector computed tomography simulation: a report of 52 consecutive cases.

          Hiroyuki Oizumi, Naoki Kanauchi, Hirohisa Kato … (2011)
          The purpose of this retrospective study was to evaluate the efficacy of anatomic thoracoscopic pulmonary segmentectomy performed under the guidance of 3-dimensional multidetector computed tomography simulation.
          Article 0 comments Cited 47 times – based on 0 reviews     Review now
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            Thoracoscopic treatment of pulmonary sequestration.

            Walter Weder, Peter B Kestenholz, Didier Lardinois … (2006)
            Pulmonary sequestration is a rare congenital malformation and may be the cause of recurrent infections or hemoptysis. It has been shown in case reports that resection by video-assisted thoracic surgery (VATS) is feasible despite the possible technical difficulties due to inflammatory changes, but its role has not been evaluated yet in a larger series of consecutively treated patients. Retrospective analysis of all consecutively thoracoscopically treated patients (between January 1991 and January 2005) with pulmonary sequestration in a single center. We included 14 patients in the study who fulfilled the criteria; seven were women. Median age was 33 years (20-64 years). The following data were analyzed for all patients: major symptoms, diagnostic procedures, treatment, and outcome. Operative parameters and findings including operating time, blood loss, anatomical location of the sequestration, and feeding vessels were evaluated. Leading symptoms were recurrent infections (10), hemoptysis (3), and chest discomfort (1). The diagnosis was made by CT scan. Additionally, an arteriography or an angio-MRI was done in three patients and one patient, respectively. Thirteen intralobar (all lower lobes, eight on the right) and one left-sided extralobar pulmonary sequestration were resected. We performed eight lobectomies, four atypical segmentectomies, one extralobar resection, and one occlusion of the aberrant artery. One case had to be converted to a thoracotomy due to bleeding from the aberrant artery. There was no mortality. Complications included pneumonia in three cases, one hemothorax, one pneumothorax after removing the chest tube, and one wound infection. All were treated conservatively. Thoracoscopic treatment of pulmonary sequestration is feasible in experienced hands. The aberrant systemic artery can be freed and dissected safely despite the frequently occurring inflammatory changes. Conversion rate to thoracotomy is low.
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              Pulmonary function after lobectomy: video-assisted thoracic surgery versus thoracotomy.

              A Kurita, W. Takiyama, S Takashima … (2000)
              Whether video-assisted thoracic surgery (VATS) improves postoperative pulmonary function is still controversial. We compared postoperative pulmonary function after VATS lobectomy and standard lobectomy. Eleven patients who had undergone standard lobectomy and 10 patients who had undergone VATS lobectomy were studied. Arterial blood gas analyses were performed on the 4th, 7th, and 14th postoperative days. Pulmonary function, including forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1.0), and peak flow rate (PFR) were measured on the 7th and 14th postoperative days (early phase), and approximately 1 year after surgery (late phase). Pulmonary function, as assessed with arterial oxygen partial pressure (PaO2) (p = 0.054), arterial oxygen saturation (O2SAT) (p = 0.063), FVC (p = 0.10), and FEV1.0 (p = 0.08), was better after VATS lobectomy than after thoracotomy on the 7th postoperative day. PFR was significantly better after VATS on both the 7th and 14th postoperative days (p = 0.008 and p = 0.03, respectively). VATS lobectomy had advantages on early postoperative pulmonary function. We conclude that VATS lobectomy is a beneficial alternative to standard thoracotomy, especially for patients with poor pulmonary reserve.
              Article 0 comments Cited 24 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Thorac Cardiovasc Surg Rep
                Journal ID (iso-abbrev): Thorac Cardiovasc Surg Rep
                Journal ID (doi): 10.1055/s-00024355
                Title: The Thoracic and Cardiovascular Surgeon Reports
                Publisher: Georg Thieme Verlag KG (Stuttgart · New York )
                ISSN (Print): 2194-7635
                ISSN (Electronic): 2194-7643
                Publication date (Electronic): 09 June 2014
                Publication date (Print): December 2014
                Volume: 3
                Issue: 1
                Pages: 42-44
                Affiliations
                [1 ]Department of General Thoracic Surgery, Dokkyo Medical University, Mibu, Tochigi, Japan
                [2 ]Department of Surgery 2, Yamagata University, Yamagata, Japan
                Author notes
                Address for correspondence Takashi Inoue, MD Department of General Thoracic Surgery, Dokkyo Medical University 880 Kitakobayashi, Mibu, Tochigi 3210293Japan takashi_inoue1980@ 123456yahoo.co.jp
                Article
                Publisher ID: 140075crt
                DOI: 10.1055/s-0034-1377065
                PMC ID: 4360677
                SO-VID: fa1a456c-4e56-4b28-aeef-c4ace24a712b
                Copyright © © Thieme Medical Publishers
                History
                Date received : 13 February 2014
                Date accepted : 31 March 2014
                Categories
                Subject: Article

                Keywords: thoracic surgery,minimally invasive surgery,lung,congenital disorder,pediatric,thoracoscopy/vats,computed tomography
                Data availability:
                Keywords: thoracic surgery, minimally invasive surgery, lung, congenital disorder, pediatric, thoracoscopy/vats, computed tomography

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