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1.
Zhonghua Er Ke Za Zhi ; 58(1): 19-24, 2020 Jan 02.
Artigo em Chinês | MEDLINE | ID: mdl-31905471

RESUMO

Objective: To summarize the diagnosis, clinical manifestations, treatment and prognosis of congenital cystic lung lesions. Methods: A retrospective study described the clinical course of 96 patients (46 female and 50 male) diagnosed with congenital cystic lung lesions treated at the Tianjin Children's Hospital from January 2010 to March 2019. The clinical findings, imaging examinations, pathological findings, treatment and follow-up were analyzed. Results: Totally 96 patients (aged from 4 days to 13 years) with congenital cystic lung lesions were included in this study. Eighty-six patients (90%) were diagnosed when they had cough and fever symptoms. Forty (42%) patients exhibited congenital cystic adenomatoid malformation, 30 underwent surgical excision, two were at emergency operations and one dead. There were 12 (13%) patients with pulmonary sequestration and four were surgical treated. Twelve (13%) patients with bronchogenic cyst were included and 4 were surgically treated. There were 3 (3%) patients with congenital lobar emphysema and one was surgically treated. Another patient with pneumothorax was operated in other hospital 2 months after discharge. Twenty-nine (30%) patients with unclassified congenital cystic lung lesions could not be definitively diagnosed by CT. Some of them were difficult to be distinguished from necrotizing pneumonia. Finally, 2 patients were diagnosed as necrotizing pneumonia after 6, 10 months follow-up. After operation 37 out of 39 patients recovered well. Conclusions: The diagnosis of congenital pulmonary cystic disease depend on imaging and pathological examination. Most patients are diagnosed when they have respiratory tract infection. The main clinical manifestations are cough and fever. The prognosis of operative management is good.


Assuntos
Cisto Broncogênico/diagnóstico , Cisto Broncogênico/cirurgia , Malformação Adenomatoide Cística Congênita do Pulmão/diagnóstico , Enfisema Pulmonar/patologia , Adolescente , Cisto Broncogênico/congênito , Sequestro Broncopulmonar/diagnóstico , Sequestro Broncopulmonar/cirurgia , Criança , Pré-Escolar , Malformação Adenomatoide Cística Congênita do Pulmão/cirurgia , Feminino , Humanos , Lactente , Masculino , Pneumonectomia , Enfisema Pulmonar/cirurgia , Estudos Retrospectivos , Resultado do Tratamento
2.
Rev Port Cir Cardiotorac Vasc ; 26(2): 159-162, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31476820

RESUMO

Pulmonary sequestration (PS) is a rare congenital malformation, even more when its arterial supply is a coronary artery. We present a case of a 68-year-old man admitted in the emergency room with an acute coronary syndrome and no evidence of significant coronary disease. Instead, he had an abnormal branch from the circumflex coronary artery nourishing a mass in the left lower pulmonary lobe. A coronary steal phenomenon was proposed to explain the clinical presentation. An anterior left thoracotomy with ligation of the abnormal branch and atypical resection of the lung segment comprising the sequestration was performed.


Assuntos
Síndrome Coronariana Aguda/etiologia , Sequestro Broncopulmonar/cirurgia , Anomalias dos Vasos Coronários/cirurgia , Pulmão/irrigação sanguínea , Idoso , Sequestro Broncopulmonar/complicações , Sequestro Broncopulmonar/diagnóstico , Anomalias dos Vasos Coronários/complicações , Anomalias dos Vasos Coronários/diagnóstico , Humanos , Masculino , Toracotomia
4.
J Med Case Rep ; 13(1): 228, 2019 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-31349794

RESUMO

BACKGROUND: The potential complications of pulmonary sequestration are serious and may include recurrent pulmonary infection, hemoptysis, and tumorigenesis. Therefore, the gold standard of treatment has been surgery. Although an adequate boundary between the nonfunctional lung and normal lung is required for the resection of pulmonary sequestration, the boundaries have been conventionally identified intraoperatively with inflation/deflation of the target segment by clamping and unclamping the relevant bronchus. The technique of visualizing the demarcation line based on near-infrared fluorescence imaging with indocyanine green was recently developed. CASE PRESENTATION: A 42-year-old Japanese woman with right Pryce III intralobar sequestration was admitted to our hospital. We planned video-assisted thoracoscopic wedge resection of the right sequestration using near-infrared fluorescence imaging with indocyanine green because of the small volume of the nonfunctional region. The aberrant artery was recognized in the pulmonary ligament; the artery was cut off after ligation. Indocyanine green at 5 mg/body was rapidly injected into the peripheral vein, and the boundary of the sequestration was clearly identified under near-infrared fluorescence imaging. CONCLUSION: Near-infrared fluorescence imaging with indocyanine green is safe and useful for the identification of the boundary of a pulmonary sequestration.


Assuntos
Sequestro Broncopulmonar/cirurgia , Pneumonectomia/métodos , Cirurgia Torácica Vídeoassistida/métodos , Sequestro Broncopulmonar/diagnóstico por imagem , Sequestro Broncopulmonar/patologia , Corantes/administração & dosagem , Feminino , Humanos , Verde de Indocianina/administração & dosagem , Margens de Excisão , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X
5.
J Cardiothorac Surg ; 14(1): 113, 2019 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-31221172

RESUMO

BACKGROUND: Extralobar sequestration is a rare congenital malformation of lung tissue, which can be combined with other foregut and cardiac abnormalities. Our case is the first to report extralobar sequestration, absence of pericardium and atrial septal defect in the same patient. CASE PRESENTATION: A 22-year-old female with atrial septal defect came for her recent atypical symptom of intermittent palpitation and shortness of breath. Her computed tomography showed a cystic mass located in left superior anterior mediastinum near the pulmonary trunk. With specious of cystic teratoma prior to video-assisted thoracoscopic surgery, she finally was diagnosed as extralobar sequestration, while incidentally found with congenital absence of pericardium during surgery. CONCLUSIONS: Extralobar sequestration, absence of pericardium and atrial septal defect can occur in the same patient. The preoperative diagnostic rate of extralobar sequestration and asymptomatic absence of pericardium remains low attributed to atypical imaging features. A cardiac magnetic resonance imaging is highly recommended if necessary. Regular follow-up is essential to asymptomatic absence of pericardium and atrial septal defect patients. To patients with extralobar sequestration, an operation could be performed.


Assuntos
Sequestro Broncopulmonar/diagnóstico , Comunicação Interatrial/diagnóstico , Neoplasias do Mediastino/diagnóstico , Pericárdio/anormalidades , Teratoma/diagnóstico , Anormalidades Múltiplas/diagnóstico , Anormalidades Múltiplas/diagnóstico por imagem , Anormalidades Múltiplas/cirurgia , Sequestro Broncopulmonar/complicações , Sequestro Broncopulmonar/diagnóstico por imagem , Sequestro Broncopulmonar/cirurgia , Diagnóstico Diferencial , Feminino , Comunicação Interatrial/complicações , Comunicação Interatrial/diagnóstico por imagem , Comunicação Interatrial/cirurgia , Humanos , Imagem por Ressonância Magnética , Neoplasias do Mediastino/complicações , Neoplasias do Mediastino/diagnóstico por imagem , Neoplasias do Mediastino/cirurgia , Teratoma/complicações , Teratoma/diagnóstico por imagem , Teratoma/cirurgia , Cirurgia Torácica Vídeoassistida , Tomografia Computadorizada por Raios X , Adulto Jovem
7.
Innovations (Phila) ; 14(2): 168-173, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31039681

RESUMO

Thoracic stent graft plus coil embolization is a promising option for management of pulmonary sequestrations. Here we present the case of a 43-year-old male with chronic recurrent chest pain and hemoptysis that was incidentally identified as having a Pryce Type I pulmonary sequestration. The patient had a known history of gastritis, alcohol abuse, chronic leg and back pain, and was incidentally found to have an anomalous artery from the descending thoracic aorta to the left lower lobe. Due to recurrent hemoptysis and refractory back pain with no other identifiable etiology, he was consented for coil embolization and thoracic endovascular aortic repair. In conjunction with interventional radiology, coil embolization of the aberrant thoracic artery was performed under fluoroscopic guidance with good graft coverage of the aberrant artery with an endovascular graft. The patient's postoperative recovery was uneventful and he reported a decrease in his chest pain. Repeat imaging including chest X-ray and CT angiography were performed prior to discharge. CT angiography demonstrated good positioning of the coils as well as the stent graft. The patient was discharged on postoperative day 1. Surgical intervention with ligation of the anomalous vessel has historically been the primary intervention for patients with Pryce Type I sequestrations, and it has yielded satisfactory results. However, thoracic stent graft in addition to coil embolization is a minimally invasive management option that should be considered as the first line of treatment because of the minimal physiologic burden on the patient and quicker recovery as compared to traditional thoracotomy.


Assuntos
Implante de Prótese Vascular/efeitos adversos , Sequestro Broncopulmonar/diagnóstico , Embolização Terapêutica/instrumentação , Hemoptise/etiologia , Adulto , Sequestro Broncopulmonar/cirurgia , Angiografia por Tomografia Computadorizada/métodos , Procedimentos Endovasculares/métodos , Hemoptise/diagnóstico , Humanos , Achados Incidentais , Masculino , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Stents , Artérias Torácicas/anormalidades , Artérias Torácicas/diagnóstico por imagem , Artérias Torácicas/cirurgia , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
9.
Ann Diagn Pathol ; 39: 78-85, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30798075

RESUMO

Pulmonary malformations are rare disorders, with cystic and pseudocystic pulmonary malformations (CPPM) the most frequent, and constitute the first cause of lobectomy in children <1 year of age. Morphological overlap of congenital cystic pulmonary lesions might correspond to a spectrum of lesions in which bronchial atresia is a common etiopathogenetic mechanism. We aimed to report the frequency of CPPM resected in a tertiary-level hospital and to evaluate the degree of agreement between presurgical and anatomopathological diagnoses. We studied 44 surgical pieces with a diagnosis of CPPM received at the Pathology Service from 2009 to 2014, resected from 39 patients, 51.3 % males, with a median age of 16.8 months. Up to 69.2% of the patients had adenomatoid malformation of pulmonary airway (AMPA), with type 2 the most frequent (55.5%). Pulmonary sequestration was present in 15.4% of patients; in two cases the diagnosis was an incidental finding during surgery for the repair of a diaphragmatic hernia. Congenital lobar hyperinflation (CLH) occurred in 7.6% cases. Bronchogenic cyst (BC) was present in 7.6% cases. Presurgical and anatomopathological diagnoses in all patients coincided in 71.8% of cases. Kappa coefficient was 0.56 for global concordance in patients with AMPA, and 0.72, 0.64, 0.37 and 0.33 for CLH, BC, and types 1 and 2 AMPA, respectively. This relatively low interobserver agreement could reflect the low reproducibility of diagnoses used in the current nomenclature. Thus, the new nomenclature must be promoted in order to allow for better reproducibility and greater clinico-pathological concordance. The anatomopathological analysis must include the intentional search for bronchial atresia.


Assuntos
Procedimentos Cirúrgicos Pulmonares/métodos , Anormalidades do Sistema Respiratório/diagnóstico , Anormalidades do Sistema Respiratório/cirurgia , Adolescente , Cisto Broncogênico/diagnóstico , Cisto Broncogênico/patologia , Cisto Broncogênico/cirurgia , Sequestro Broncopulmonar/diagnóstico , Sequestro Broncopulmonar/patologia , Sequestro Broncopulmonar/cirurgia , Criança , Pré-Escolar , Estudos Transversais , Malformação Adenomatoide Cística Congênita do Pulmão/diagnóstico , Malformação Adenomatoide Cística Congênita do Pulmão/patologia , Malformação Adenomatoide Cística Congênita do Pulmão/cirurgia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Variações Dependentes do Observador , Enfisema Pulmonar/congênito , Enfisema Pulmonar/diagnóstico , Enfisema Pulmonar/patologia , Enfisema Pulmonar/cirurgia , Anormalidades do Sistema Respiratório/patologia , Estudos Retrospectivos , Centros de Atenção Terciária
10.
Rev Mal Respir ; 36(4): 543-546, 2019 Apr.
Artigo em Francês | MEDLINE | ID: mdl-30711346

RESUMO

INTRODUCTION: Bronchopulmonary sequestration is a rare congenital abnormality characterized by the presence of a non-functioning mass of lung tissue which receives an aberrant arterial supply from systemic circulation. CASE REPORT: We describe the case of a 30-year-old man who presented with recurrent episodes of mild hemoptysis. CT angiography revealed a right inferior lobar sequestration supplied by three systemic arteries. The patient underwent thoracotomy with right lower lobectomy and section-ligature of the three abnormal vessels. CONCLUSION: This case highlights the radiological features as well as the intraoperative appearances of this rare anomaly.


Assuntos
Sequestro Broncopulmonar/diagnóstico , Sequestro Broncopulmonar/cirurgia , Adulto , Sequestro Broncopulmonar/complicações , Embolização Terapêutica , Hemoptise/diagnóstico , Hemoptise/etiologia , Hemoptise/cirurgia , Humanos , Pulmão/patologia , Pulmão/cirurgia , Masculino , Pneumonectomia , Toracotomia
11.
Rev Mal Respir ; 36(2): 129-134, 2019 Feb.
Artigo em Francês | MEDLINE | ID: mdl-30686557

RESUMO

BACKGROUND: Until now, the traditional procedure to treat intralobar pulmonary sequestration (ILS) in adults has been a lobectomy performed by open thoracotomy. We have reviewed our data to observe if the surgical management of these lesions has evolved over the last years. METHODS: We retrospectively reviewed the records of the patients who were operated for an ILS either by posterolateral thoracotomy (PLT group), or by thoracoscopy (TS group) between 2000 and 2016. RESULTS: Eighteen patients were operated for a SIL during this period. Prior to 2011, all resections were performed by thoracotomy (n=6) and after 2011 the surgical approach was either a thoracotomy (n=5) or a thoracoscopy (n=7). There was one conversion because of dense pleural adhesions and this patient was integrated in the PLT group for further analysis. ILS were more frequently encountered on the left side (n=12, 66.6 %) than on the right one (n=6, 33.3 %) and exclusively in the lower lobes. All patients of the PLT group underwent a lobectomy. In the TS group, 5 patients underwent a sublobar resection (2 segmentectomiesS9+10, 1 basilar segmentectomy and 2 atypical resections). There was no mortality. In the PLT group, 5 patients (45 %) had complications versus one patient (14 %) in the TS group. The mean hospital stay was 7.4 days in the PLT group versus 5.4 days in the TS group. CONCLUSIONS: These data confirm that ILS can be safely treated by a sublobar resection that should be performed, whenever possible, thoracoscopically.


Assuntos
Sequestro Broncopulmonar/cirurgia , Pneumonectomia/tendências , Adolescente , Adulto , Sequestro Broncopulmonar/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonectomia/efeitos adversos , Pneumonectomia/métodos , Pneumonectomia/estatística & dados numéricos , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Cirurgia Torácica Vídeoassistida/efeitos adversos , Cirurgia Torácica Vídeoassistida/métodos , Cirurgia Torácica Vídeoassistida/tendências , Toracotomia/efeitos adversos , Toracotomia/métodos , Toracotomia/estatística & dados numéricos , Toracotomia/tendências , Resultado do Tratamento , Adulto Jovem
12.
Fetal Diagn Ther ; 45(3): 162-167, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29734144

RESUMO

INTRODUCTION: The aim of this study is to evaluate long-term neurodevelopmental and respiratory outcome after fetal therapy for fetal pleural effusion, congenital cystic adenomatoid malformation, and bronchopulmonary sequestration. METHODS: Children ≥18 months of age underwent an assessment of neurologic, motor, and cognitive development. Medical records were reviewed to determine respiratory outcome. Behavioral outcome was assessed using the Child Behavioral Checklist. RESULTS: Between 2001 and 2016, 63 fetuses with fetal hydrops secondary to thoracic abnormalities were treated at our center. Overall perinatal survival was 64% (40/63). Twenty-six children were included for follow-up (median age 55 months). Severe neurodevelopmental impairment (NDI) was detected in 15% (4/26). Three out of 4 children with severe NDI had associated causes contributing to the impairment. Overall adverse outcome, including perinatal mortality or NDI, was 55% (27/49). Fifteen percent (4/26) had severe respiratory sequelae. Parents did not report more behavioral problems than Dutch norms. DISCUSSION: Our results suggest that severe NDI in this specific high-risk cohort occurs in 15%, which is above the range of the incidence of NDI reported in case series treated with other fetal therapies (5-10%). Large multicenter studies and an international web-based registry are warranted to prospectively gather outcome data at fixed time points.


Assuntos
Sequestro Broncopulmonar/cirurgia , Malformação Adenomatoide Cística Congênita do Pulmão/cirurgia , Doenças Fetais/cirurgia , Terapias Fetais/efeitos adversos , Hidropisia Fetal/cirurgia , Transtornos do Neurodesenvolvimento/etiologia , Derrame Pleural/cirurgia , Adulto , Sequestro Broncopulmonar/diagnóstico por imagem , Sequestro Broncopulmonar/mortalidade , Criança , Comportamento Infantil/fisiologia , Pré-Escolar , Malformação Adenomatoide Cística Congênita do Pulmão/diagnóstico por imagem , Malformação Adenomatoide Cística Congênita do Pulmão/mortalidade , Feminino , Doenças Fetais/diagnóstico por imagem , Doenças Fetais/mortalidade , Terapias Fetais/métodos , Humanos , Hidropisia Fetal/diagnóstico por imagem , Hidropisia Fetal/mortalidade , Lactente , Masculino , Derrame Pleural/diagnóstico por imagem , Derrame Pleural/mortalidade , Gravidez , Estudos Retrospectivos , Taxa de Sobrevida , Resultado do Tratamento , Ultrassonografia Pré-Natal
14.
Interact Cardiovasc Thorac Surg ; 28(3): 483-484, 2019 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-30124870

RESUMO

This study aimed to report the case of a patient diagnosed with pulmonary sequestration accompanied by an intermittent haematemesis as the initial and life-threatening symptom. Emergent surgical intervention finally confirmed a rare direct fistula formation between the arterial blood supply of pulmonary sequestration and the oesophagus, which led to intermittent upper gastrointestinal haemorrhage. To our knowledge, this is the first case reported with this kind of fistula formation.


Assuntos
Sequestro Broncopulmonar/complicações , Fístula Esofágica/complicações , Hematemese/etiologia , Fístula Vascular/complicações , Sequestro Broncopulmonar/diagnóstico , Sequestro Broncopulmonar/cirurgia , Fístula Esofágica/diagnóstico , Fístula Esofágica/cirurgia , Esôfago/diagnóstico por imagem , Esôfago/cirurgia , Hematemese/diagnóstico , Hematemese/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonectomia , Tomografia Computadorizada por Raios X , Fístula Vascular/diagnóstico , Fístula Vascular/cirurgia , Procedimentos Cirúrgicos Vasculares/métodos
15.
Eur J Pediatr Surg ; 29(1): 49-52, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30103238

RESUMO

INTRODUCTION: Rhabdomyomatous dysplasia (RD) is a pathologic finding in CPAMs that was incorrectly attributed to their malignant potential. The increasing recognition of extrathoracic (intradiaphragmatic and intraabdominal) congenital pulmonary airway malformations (CPAMs) offers a clue to the origin of RD. We hypothesize that the presence of RD is related to the CPAM's anatomic location. MATERIALS AND METHODS: Retrospective review was performed of all children who underwent resection of a CPAM during a 10-year period. The age at the time of operation, location of the CPAM, and pathologic findings were collected. Peridiaphragmatic location was defined as within the inferior pulmonary ligament, deep to the diaphragmatic portion of the parietal pleura ("intradiaphragmatic") or adjacent to the abdominal side of the diaphragm. Statistical analysis was performed using Fisher's exact test for 2 × 2 tables. RESULTS: Twenty-six patients with CPAM were identified. Preoperative imaging was performed by computed tomography (CT) scan (16/26), ultrasound (5/26), magnetic resonance imaging (MRI) (1/26), and chest radiograph (4/26). The median age at resection was 15 months. Of these, 16 were pure cystic adenomatoid malformations, 4 were extralobar sequestrations, 4 were intralobar sequestrations, and 2 were bronchogenic cysts. Nine lesions were peridiaphragmatic with four being intradiaphragmatic (44%). Eight of the nine resected peridiaphragmatic lesions contained histologic evidence of rhabdomyomatous changes (89%, confidence interval [CI] 52-99%). None of the other lesions contained RD (CI 0-19%, p < 0.001). CONCLUSION: RD was seen exclusively, and in virtually all peridiaphragmatic CPAMs. While the exact significance of RD remains unclear, it may represent incorporation of striated muscle tissue associated with the developing diaphragm.


Assuntos
Diafragma/patologia , Pulmão/anormalidades , Pulmão/patologia , Cisto Broncogênico/diagnóstico por imagem , Cisto Broncogênico/patologia , Cisto Broncogênico/cirurgia , Sequestro Broncopulmonar/diagnóstico por imagem , Sequestro Broncopulmonar/patologia , Sequestro Broncopulmonar/cirurgia , Malformação Adenomatoide Cística Congênita do Pulmão/diagnóstico por imagem , Malformação Adenomatoide Cística Congênita do Pulmão/patologia , Malformação Adenomatoide Cística Congênita do Pulmão/cirurgia , Diafragma/diagnóstico por imagem , Diafragma/cirurgia , Humanos , Lactente , Pulmão/diagnóstico por imagem , Pulmão/cirurgia , Estudos Retrospectivos
16.
Thorac Cardiovasc Surg ; 67(1): 73-78, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30165709

RESUMO

OBJECTIVE: The aim of this report is to summarize the experience of completely video-assisted thoracoscopic surgery (VATS) for pulmonary sequestration in a single center and to evaluate the long-term outcome in a larger series of patients. METHODS: The data of 35 pulmonary sequestrations who received completely VATS consecutively in Peking University People's Hospital between January 2008 and November 2017 were retrospectively reviewed. Twenty-three females and twelve males with an average of 38 years old were included. RESULTS: A total of 28 (80%) patients had preoperative symptoms; leading symptoms were recurrent infections (22), fever (11), hemoptysis (11), chest pain (9), and shortness of breath (4). Twenty-nine (82.9%) patients were intralobar pulmonary sequestration (22 in the left lower lobe, 6 in the right lower lobe, and 1 in the left upper lobe) and six (17.1%) patients were extralobar pulmonary sequestration. All the patients underwent VATS excision successfully, 26 underwent lobectomy, 2 underwent wedge resection, 1 underwent occlusion of the aberrant artery, and 6 underwent mass resection in all of those with extralobar pulmonary sequestration. The median surgery time and estimated blood loss was 150 (75-300) minutes and 50 (10-600) mL, respectively. There was no mortality. Only one patient suffered postoperative complication (recurrent laryngeal nerve injury). During the median follow-up period of 57 months, none of the patients presented recurrence. CONCLUSIONS: Completely VATS was a safe and effective mini-invasive procedure for pulmonary sequestration in an experienced team. Its long-term outcome was remarkable.


Assuntos
Sequestro Broncopulmonar/cirurgia , Pneumonectomia/métodos , Cirurgia Torácica Vídeoassistida , Adolescente , Adulto , Idoso , Perda Sanguínea Cirúrgica , Sequestro Broncopulmonar/diagnóstico por imagem , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Pneumonectomia/efeitos adversos , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Fatores de Risco , Cirurgia Torácica Vídeoassistida/efeitos adversos , Fatores de Tempo , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Adulto Jovem
17.
Interact Cardiovasc Thorac Surg ; 28(1): 161-163, 2019 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-29982491

RESUMO

An extralobar pulmonary sequestration (EPS) associated with a contralateral aorto-to-pulmonary vein fistula is rare. We report the case of a female newborn with left EPS fed by an artery originating from the distal thoracic aorta and, symmetrically on the controlateral side, an artery shunting in the inferior right pulmonary vein. Echocardiography showed dilatation of the left atrium. On the 34th day since birth (weight 4500 g), the patient was operated on thoracoscopically. The EPS was closed with a 3-mm sealing system, divided and removed. A window in the mediastinal pleura was created, and the origin of the fistula was identified and sealed. The postoperative course was uneventful. The patient was discharged on Day 4 with no echocardiographic signs of persistence of the fistula and of the congestive heart failure. This is the first case report of a thoracic large systemic circulation-to-pulmonary vein fistula causing heart failure associated with EPS. The thoracoscopic monolateral approach and the availability of 3-mm instruments guaranteed a maximum level of minimal invasiveness.


Assuntos
Anormalidades Múltiplas , Aorta Torácica/anormalidades , Fístula Arteriovenosa/cirurgia , Sequestro Broncopulmonar/cirurgia , Veias Pulmonares/anormalidades , Toracoscopia/métodos , Procedimentos Cirúrgicos Vasculares/métodos , Aorta Torácica/diagnóstico por imagem , Aorta Torácica/cirurgia , Fístula Arteriovenosa/diagnóstico , Sequestro Broncopulmonar/diagnóstico , Angiografia por Tomografia Computadorizada , Ecocardiografia , Feminino , Humanos , Recém-Nascido , Imagem por Ressonância Magnética , Veias Pulmonares/diagnóstico por imagem , Veias Pulmonares/cirurgia
18.
J Pediatr Surg ; 54(7): 1286-1292, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30291025

RESUMO

OBJECTIVE: This study was performed to explore the clinical features, typing, distribution, and treatment of pulmonary sequestration (PS), with the aim of improving the awareness and treatment of this condition. METHODS: Clinical data regarding surgical procedures, outcomes, and prognosis of 208 pediatric patients with PS who were treated in our center from January 2005 to October 2017 were retrospectively analyzed. RESULTS: PS was confirmed by ultrasonography, enhanced computed tomography (CT), and/or magnetic resonance imaging (MRI) before surgery, and the surgeries were smoothly performed in all 208 patients (138 males, 70 females; age, 1 month to 14 years; mean age, 19.70 ±â€¯48.82 months). The operative time ranged from 10 to 230 min (mean, 70 ±â€¯48.75 min), and the intraoperative blood loss volume ranged from 1 to 200 ml (mean, 5 ±â€¯18 ml). PS was located in multiple sites of the thoracic cavity and was also found in some rare locations such as the neck and abdomen. The feeding arteries of the PS mainly arose from the thoracic aorta or abdominal aorta, and a few of them originated from other vessels in the systemic circulation. The venous drainage differed between intralobar and extralobar PS: in patients with intralobar PS, the venous drainage was mainly via the pulmonary veins, especially the lower pulmonary veins; in patients with extralobar PS, the venous drainage was via the azygos vein and hemiazygos vein or reached the right atrium via the vena cava. The infection rate in children with intralobar sequestration was 71.17% (79/111), and that in children with extralobar sequestration was 31.37% (16/51). CONCLUSION: PS has increasingly been detected by prenatal ultrasonography, and enhanced CT and MRI are the main techniques for diagnosing PS. Once confirmed, PS should be surgically resected. We choose an age of 6 to 12 months for surgical resection. Minimally invasive video-assisted thoracic surgery has many advantages in the treatment of PS and can be the treatment of choice for this condition. TYPE OF STUDY: Treatment Study. LEVEL OF EVIDENCE: Level III.


Assuntos
Sequestro Broncopulmonar/diagnóstico , Sequestro Broncopulmonar/cirurgia , Adolescente , Sequestro Broncopulmonar/diagnóstico por imagem , Sequestro Broncopulmonar/fisiopatologia , Criança , Pré-Escolar , Diagnóstico por Imagem , Feminino , Humanos , Lactente , Masculino , Prognóstico , Estudos Retrospectivos , Cirurgia Torácica Vídeoassistida/métodos , Toracotomia , Resultado do Tratamento
19.
Ann Thorac Surg ; 108(1): e43-e44, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30529677

RESUMO

A 49-year-old woman presented after a respiratory infection with an abnormal chest roentgenogram demonstrating a cystic calcified mass at the base of the right lung. A chest computed tomographic angiogram demonstrated that the blood supply arose from the abdominal aorta. This extralobar sequestration was surgically resected using video-assisted thoracoscopy without complication. The pathology report showed a cystic hamartoma. This case highlights the importance of preoperative evaluation of the blood supply of suspected sequestrations and the very rare disorder that was found.


Assuntos
Sequestro Broncopulmonar/cirurgia , Hamartoma/complicações , Pneumopatias/complicações , Sequestro Broncopulmonar/etiologia , Feminino , Hamartoma/cirurgia , Humanos , Pneumopatias/cirurgia , Pessoa de Meia-Idade , Cirurgia Torácica Vídeoassistida
20.
J Coll Physicians Surg Pak ; 28(9): S204-S206, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30173699

RESUMO

We report a rare case of bronchopulmonary extralobar sequestration in a 9-year girl mimicking pulmonary tuberculosis. Patient had recurrent chest infections and two episodes of massive hemoptysis. Preoperative x-ray chest showed an opacity in left lower lobe and computed tomography-aortogram showed that the lesion had systemic arterial supply from celiac trunk. Diagnosis of pulmonary sequestration was made and left lateral muscle sparing thoracotomy was planned. Intraoperatively, extralobar sequestration was found with dual systemic blood supply. Histopathology confirmed it to be a hybrid lesion.


Assuntos
Adenoma/congênito , Cistos/congênito , Pulmão/diagnóstico por imagem , Adenoma/complicações , Adenoma/cirurgia , Aortografia , Sequestro Broncopulmonar/diagnóstico por imagem , Sequestro Broncopulmonar/cirurgia , Criança , Malformação Adenomatoide Cística Congênita do Pulmão/diagnóstico por imagem , Malformação Adenomatoide Cística Congênita do Pulmão/cirurgia , Cistos/complicações , Cistos/cirurgia , Diagnóstico Diferencial , Erros de Diagnóstico , Feminino , Humanos , Pulmão/irrigação sanguínea , Síndrome do Desconforto Respiratório do Recém-Nascido/etiologia , Toracotomia , Tomografia Computadorizada por Raios X , Tuberculose Pulmonar/diagnóstico
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