Yang Liu, Shixu Fang, Shuo Wang, Qian Luo, Xixian Ke* and Yongxiang Song*
Department of Thoracic Surgery, The Affiliated Hospital of Zunyi Medical University, ChinaFulltext PDF
Background: Pulmonary Sequestration (PS) is a relatively rare lung deformity. Surgical resection is the best treatment for asymptomatic PS. Although local resection should be the first choice for intralobular PS, there are still no published reports on how to distinguish the sequestered lung tissue from normal lung tissue and furthermore, how to remove it during local resection. Case Report: This paper describes a 46-year-old female patient without the typical symptoms of PS or a history of tuberculosis. Enhanced computed tomography showed sequestered lung tissue with two abnormal blood supply arteries. After undergoing preoperative preparation, the patient was placed in the right decubitus position, and under general anesthesia, Video-Assisted Thoracoscopic Surgery (VATS) was performed; the patient was initially considered to have Intralobar Sequestration (ILS), with two abnormal blood vessels entering the posterior basal ganglia from the thoracic aorta. The diameters of the basal segments were 8 mm and 5 mm. A few minutes after the abnormal blood supply artery was severed, we observed a significant change in the color of the sequestered lung tissue, which was consistent with that of a healthy lung. Then, we confirmed the hypothesis that the electric hook placed as a marker was at the boundary between the two lobes. The postoperative course was uneventful, the pathological findings showed signs of sequestration of the left lower lobe, and she was discharged on the 5th day after surgery. CT examination of the chest at 6 months after surgery showed that the lungs remodeled well without inflammation. Conclusion: Typically, the surgical treatment of pulmonary ILS combined with healthy lung tissue in the lobe will cause irreparable tissue loss to the patient. We attempted to mark the lung during surgery to ensure that as much healthy lung tissue was preserved as possible after complete resection of the sequestered lung tissue to improve the patient's postoperative quality of life. The patient recovered well after surgery, confirming the effectiveness of our procedure; this method provides an alternative for patients with PS who can be treated with partial resection; however, a large number of cases are still required to further support these findings.
Liu Y, Fang S, Wang S, Luo Q, Ke X, Song Y. Intralobar Pulmonary Sequestration with Successful Preservation of the Lung Lobe after Intraoperative Marking: A Case Report. Clin Surg. 2022; 7: 3498..