Surgical approach in pulmonary sequestrations: An institutional experience with 32 cases

KAVUKÇU, Şevket; SAKALLI, Mehmet Ali; YENIGÜN, BÜLENT MUSTAFA; ÖZKAN, Murat; AKAL, Rıfat Murat; KAYI CANGIR, Ayten; YÜKSEL, Cabir; ENÖN, Serkan

Surgical approach in pulmonary sequestrations: An institutional experience with 32 cases

Murat ÖZKAN, (Ankara Üniversitesi, Tıp Fakültesi, Göğüs Cerrahisi Anabilim Dalı, Ankara, Türkiye)

Mehmet Ali SAKALLI, (Ankara Üniversitesi, Tıp Fakültesi, Göğüs Cerrahisi Anabilim Dalı, Ankara, Türkiye)

Serkan ENÖN, (Ankara Üniversitesi, Tıp Fakültesi, Göğüs Cerrahisi Anabilim Dalı, Ankara, Türkiye)

Bülent Mustafa YENİGÜN, (Ankara Üniversitesi, Tıp Fakültesi, Göğüs Cerrahisi Anabilim Dalı, Ankara, Türkiye)

Cabir YÜKSEL, (Ankara Üniversitesi, Tıp Fakültesi, Göğüs Cerrahisi Anabilim Dalı, Ankara, Türkiye)

Rıfat Murat AKAL, (Ankara Üniversitesi, Tıp Fakültesi, Göğüs Cerrahisi Anabilim Dalı, Ankara, Türkiye)

Şevket KAVUKÇU, (Ankara Üniversitesi, Tıp Fakültesi, Göğüs Cerrahisi Anabilim Dalı, Ankara, Türkiye)

Ayten Kayı CANGIR (Ankara Üniversitesi, Tıp Fakültesi, Göğüs Cerrahisi Anabilim Dalı, Ankara, Türkiye)

Türk Göğüs Kalp Damar Cerrahisi Dergisi

1 0

Yıl: 2017 Cilt: 25 Sayı: 1 Sayfa Aralığı: 96 - 102 Metin Dili: İngilizce İndeks Tarihi: 07-11-2018

Surgical approach in pulmonary sequestrations: An institutional experience with 32 cases

Öz:

Background: This study aims to present our experiences on surgical treatment of pulmonary sequestrations. Methods: A total of 32 patients (16 males, 16 females; mean age 32.7±13.4 years; range 4 to 61 years) who were performed surgical resection for pulmonary sequestration between January 1987 and December 2015 were reviewed. Patients were evaluated according to demographics, symptoms, diagnostic methods, type, localization and vascular characteristics of pulmonary sequestration, type of resection, complications, and outcomes.Results: Of the patients, intralobar sequestration was detected in 87.5% and extralobar sequestration in 12.5%. Intralobar sequestration was located in the lower lobe in 89.3% and in the upper lobe in 10.7% of the patients. All extralobar sequestrations were located in the left hemithorax; 75% was located at the base of the hemithorax and 25% was located at the apex. Of the patients, lobectomy was performed in 53.1%, wedge resection in 25%, mass excision in 12.5%, and segmentectomy in 9.4%. Postoperative complications occurred in 18.8% of the patients as prolonged air leak in three patients, wound infection in two patients, and empyema in one patient. No mortality was observed. Median follow-up period was 42 months (range 3 to 105 months) and we detected that patients remained asymptomatic.Conclusion: Although pulmonary sequestration has a benign course, it should be removed owing to its severe complications even if patients are asymptomatic. Computed tomographic angiography is a good diagnostic tool for pulmonary sequestrations.

Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi

Pulmoner sekestrasyonlarda cerrahi yaklaşım: 32 olgu ile kurumsal deneyim

Öz:

Amaç: Bu çalışmada, pulmoner sekestrasyonların cerrahi tedavisi hakkında deneyimlerimiz sunuldu. Çalışma planı: Pulmoner sekestrasyon nedeniyle Ocak 1987 - Aralık 2015 tarihleri arasında cerrahi rezeksiyon uygulanan toplam 32 hasta (16 erkek, 16 kadın; ort. yaş 32.7±13.4 yıl; dağılım 4-61 yıl) incelendi. Hastalar demografik özellikleri, semptomlar, tanı yöntemleri, pulmoner sekestrasyonun tipi, yerleşim yeri ve vasküler özellikleri, rezeksiyon tipi, komplikasyonlar ve sonuçlara göre değerlendirildi. Bulgular: Hastaların %87.5’inde intralober, %12.5’inde ekstralober sekestrasyon saptandı. Intralober sekestrasyon hastaların %89.3’ünde alt lob, %10.7’sinde üst lob yerleşimli idi. Bütün ekstralober sekestrasyonlar sol hemitoraksta olmak üzere; %75’i hemitoraks tabanı, %25’i ise apeks yerleşimli idi. Hastaların %53.1’ine lobektomi, %25’ine kama rezeksiyon, %12.5’ine kütle eksizyonu, %9.4’üne segmentektomi uygulandı. Ameliyat sonrası komplikasyonlar üç hastada uzamış hava kaçağı, iki hastada yara yeri enfeksiyonu ve bir hastada ampiyem olmak üzere hastaların %18.8’inde gelişti. Mortalite izlenmedi. Ortanca takip süresi 42 ay (dağılım 3-105 ay) idi ve hastaların asemptomatik kaldığı saptandı. Sonuç: Pulmoner sekestrasyon benign seyirli olmasına rağmen ciddi komplikasyonları nedeni ile hastalar asemptomatik olsa da çıkarılmalıdır. Bilgisayarlı tomografik anjiyografi pulmoner sekestrasyonlara yaklaşımda cerraha yol gösteren iyi bir tanı aracıdır

Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

23. Gatzinsky P, Olling S. A case of carcinoma in intralobar pulmonary sequestration. Thorac Cardiovasc Surg 1988;36:290-1.
22. Fabre OH, Porte HL, Godart FR, Rey C, Wurtz AJ. Long-term cardiovascular consequences of undiagnosed intralobar pulmonary sequestration. Ann Thorac Surg 1998;65:1144-6.
21. Beasley MB, Travis WD, Rubin E. The respiratory system. In: Rubin R, Strayer DS, editors. Rubin’s Pathology: Clinicopathologic Foundations of Medicine. 6th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2012. p. 541.
20. Sun X, Xiao Y. Pulmonary sequestration in adult patients: a retrospective study. Eur J Cardiothorac Surg 2015;48:279-82.
19. Wan IY, Lee TW, Sihoe AD, Ng CS, Yim AP. Video-assisted thoracic surgery lobectomy for pulmonary sequestration. Ann Thorac Surg 2002;73:639-40.
18. Goto T, Toya K, Wakaki M, Kato R. Resection of intralobar pulmonary sequestration after coil embolization of aberrant arteries: report of a case. Surg Today 2013;43:923-5.
17. Cho MJ, Kim DY, Kim SC, Kim KS, Kim EA, Lee BS. Embolization versus surgical resection of pulmonary sequestration: clinical experiences with a thoracoscopic approach. J Pediatr Surg 2012;47:2228-33.
16. Chien KJ, Huang TC, Lin CC, Lee CL, Hsieh KS, Weng KP. Early and late outcomes of coil embolization of pulmonary sequestration in children. Circ J 2009;73:938-42.
15. Yue SW, Guo H, Zhang YG, Gao JB, Ma XX, Ding PX. The clinical value of computer tomographic angiography for the diagnosis and therapeutic planning of patients with pulmonary sequestration. Eur J Cardiothorac Surg 2013;43:946-51.
14. Sancak T, Cangir AK, Atasoy C, Ozdemir N. The role of contrast enhanced three-dimensional MR angiography in pulmonary sequestration. Interact Cardiovasc Thorac Surg 2003;2:480-2.
13. Liu C, Pu Q, Ma L, Mei J, Xiao Z, Liao H, et al. Video-assisted thoracic surgery for pulmonary sequestration compared with posterolateral thoracotomy. J Thorac Cardiovasc Surg 2013;146:557-61.
12. Evman S, Batirel HF, Yüksel M. Late diagnosis of extralobar pulmonary sequestration: two cases with an uncommon malformation. Thorac Cardiovasc Surg 2012;60:485-7.
11. Berna P, Cazes A, Bagan P, Riquet M. Intralobar sequestration in adult patients. Interact Cardiovasc Thorac Surg 2011;12:970-2.
10. Halkic N, Cuénoud PF, Corthésy ME, Ksontini R, Boumghar M. Pulmonary sequestration: a review of 26 cases. Eur J Cardiothorac Surg 1998;14:127-33.
9. Petersen G, Martin U, Singhal A, Criner GJ. Intralobar sequestration in the middle-aged and elderly adult: recognition and radiographic evaluation. J Thorac Cardiovasc Surg 2003;126:2086-90.
8. Feng X, Xiong XL. Extralobar pulmonary sequestration in the right lower thoracic region associated with esophageal fistula. Thorac Cardiovasc Surg 2013;61:507-9.
7. Corbett HJ, Humphrey GM. Pulmonary sequestration. Paediatr Respir Rev 2004;5:59-68.
6. Wei Y, Li F. Pulmonary sequestration: a retrospective analysis of 2625 cases in China. Eur J Cardiothorac Surg 2011;40:39-42.
5. Gezer S, Taştepe I, Sirmali M, Findik G, Türüt H, Kaya S, et al. Pulmonary sequestration: a single-institutional series composed of 27 cases. J Thorac Cardiovasc Surg 2007;133:955-9.
4. Yucel O, Gurkok S, Gozubuyuk A, Caylak H, Sapmaz E, Kavakli K, et al. Diagnosis and surgical treatment of pulmonary sequestration. Thorac Cardiovasc Surg 2008;56:154-7.
3. Van Raemdonck D, De Boeck K, Devlieger H, Demedts M, Moerman P, Coosemans W, et al. Pulmonary sequestration: a comparison between pediatric and adult patients. Eur J Cardiothorac Surg 2001;19:388-95.
2. Lin CH, Chuang CY, Hsia JY, Lee MC, Shai SE, Yang SS, et al. Pulmonary sequestration-differences in diagnosis and treatment in a single institution. J Chin Med Assoc 2013;76:385-9.
1. Savic B, Birtel FJ, Tholen W, Funke HD, Knoche R. Lung sequestration: report of seven cases and review of 540 published cases. Thorax 1979;34:96-101.

APA	ÖZKAN M, SAKALLI M, ENÖN S, YENIGÜN B, YÜKSEL C, AKAL R, KAVUKÇU Ş, KAYI CANGIR A (2017). Surgical approach in pulmonary sequestrations: An institutional experience with 32 cases. , 96 - 102.
Chicago	ÖZKAN Murat,SAKALLI Mehmet Ali,ENÖN Serkan,YENIGÜN BÜLENT MUSTAFA,YÜKSEL Cabir,AKAL Rıfat Murat,KAVUKÇU Şevket,KAYI CANGIR Ayten Surgical approach in pulmonary sequestrations: An institutional experience with 32 cases. (2017): 96 - 102.
MLA	ÖZKAN Murat,SAKALLI Mehmet Ali,ENÖN Serkan,YENIGÜN BÜLENT MUSTAFA,YÜKSEL Cabir,AKAL Rıfat Murat,KAVUKÇU Şevket,KAYI CANGIR Ayten Surgical approach in pulmonary sequestrations: An institutional experience with 32 cases. , 2017, ss.96 - 102.
AMA	ÖZKAN M,SAKALLI M,ENÖN S,YENIGÜN B,YÜKSEL C,AKAL R,KAVUKÇU Ş,KAYI CANGIR A Surgical approach in pulmonary sequestrations: An institutional experience with 32 cases. . 2017; 96 - 102.
Vancouver	ÖZKAN M,SAKALLI M,ENÖN S,YENIGÜN B,YÜKSEL C,AKAL R,KAVUKÇU Ş,KAYI CANGIR A Surgical approach in pulmonary sequestrations: An institutional experience with 32 cases. . 2017; 96 - 102.
IEEE	ÖZKAN M,SAKALLI M,ENÖN S,YENIGÜN B,YÜKSEL C,AKAL R,KAVUKÇU Ş,KAYI CANGIR A "Surgical approach in pulmonary sequestrations: An institutional experience with 32 cases." , ss.96 - 102, 2017.
ISNAD	ÖZKAN, Murat vd. "Surgical approach in pulmonary sequestrations: An institutional experience with 32 cases". (2017), 96-102.

APA	ÖZKAN M, SAKALLI M, ENÖN S, YENIGÜN B, YÜKSEL C, AKAL R, KAVUKÇU Ş, KAYI CANGIR A (2017). Surgical approach in pulmonary sequestrations: An institutional experience with 32 cases. Türk Göğüs Kalp Damar Cerrahisi Dergisi, 25(1), 96 - 102.
Chicago	ÖZKAN Murat,SAKALLI Mehmet Ali,ENÖN Serkan,YENIGÜN BÜLENT MUSTAFA,YÜKSEL Cabir,AKAL Rıfat Murat,KAVUKÇU Şevket,KAYI CANGIR Ayten Surgical approach in pulmonary sequestrations: An institutional experience with 32 cases. Türk Göğüs Kalp Damar Cerrahisi Dergisi 25, no.1 (2017): 96 - 102.
MLA	ÖZKAN Murat,SAKALLI Mehmet Ali,ENÖN Serkan,YENIGÜN BÜLENT MUSTAFA,YÜKSEL Cabir,AKAL Rıfat Murat,KAVUKÇU Şevket,KAYI CANGIR Ayten Surgical approach in pulmonary sequestrations: An institutional experience with 32 cases. Türk Göğüs Kalp Damar Cerrahisi Dergisi, vol.25, no.1, 2017, ss.96 - 102.
AMA	ÖZKAN M,SAKALLI M,ENÖN S,YENIGÜN B,YÜKSEL C,AKAL R,KAVUKÇU Ş,KAYI CANGIR A Surgical approach in pulmonary sequestrations: An institutional experience with 32 cases. Türk Göğüs Kalp Damar Cerrahisi Dergisi. 2017; 25(1): 96 - 102.
Vancouver	ÖZKAN M,SAKALLI M,ENÖN S,YENIGÜN B,YÜKSEL C,AKAL R,KAVUKÇU Ş,KAYI CANGIR A Surgical approach in pulmonary sequestrations: An institutional experience with 32 cases. Türk Göğüs Kalp Damar Cerrahisi Dergisi. 2017; 25(1): 96 - 102.
IEEE	ÖZKAN M,SAKALLI M,ENÖN S,YENIGÜN B,YÜKSEL C,AKAL R,KAVUKÇU Ş,KAYI CANGIR A "Surgical approach in pulmonary sequestrations: An institutional experience with 32 cases." Türk Göğüs Kalp Damar Cerrahisi Dergisi, 25, ss.96 - 102, 2017.
ISNAD	ÖZKAN, Murat vd. "Surgical approach in pulmonary sequestrations: An institutional experience with 32 cases". Türk Göğüs Kalp Damar Cerrahisi Dergisi 25/1 (2017), 96-102.