Pulmonary Sequestration:8Cases Report And Reveive Of Literature

Purpose To review the experience of the diagnosis, differential diagnosis and surgical management of pulmonary sequestrations, to find the reasons of missed diagnosis and misdiagnosis of pulmonary sequestrations. To have a better understanding of the clinic characteristics of pulmonary sequestration, and improve the ability to make a correct preoperative diagnosis.Materials and method The clinical data of8patients with pulmonary sequestrations treated by surgery between February1993and April2012at the tumor hospital of Guangxi medical university, proved by pathology, and analyzed the clinical features such as the clinical symptoms, radiology examination and preoperative misdiagnosis. The effete of surgical were observed at the same time.Results±8patients were included in this article,3male and5female, age range:26-68years (mean45.5).3cases were preoperative diagnosed as pulmonary sequestration,1as lung cancer,2as pulmonary cyst,l as pulmonary inflammatory pseudotumor.②linical symptoms:The most common clinical symptoms of the8patients were cough and expectoration.1case presented with fever,4case presented with hemoptysis,1case used to suffer from chest pain,1case presented with chest tightness and one case without any symptoms. Those patients had suffer these for from1week to45years.2cases had moist rales in their chest.3of them had a history of smoking.㏑adiology:8cases chest X-ray showed shadows in the lungs,3patients were diagnosed preoperatively by the contrast enhanced spiral CT scanning, which shown a aberrant artery entering the cyst.④iber bronchoscope examination found no positive⑤Pulmonary function:3cases had moderate restrictive ventilation dysfunction, low lung capacity,3cases had mild restrictive ventilation dysfunction and2cases in the normal range.⑥reatment:All cases received surgical resection successfully without any death during operation and without serious postoperative complications. Pulmonary sequestration was confirmed pathologically in all patients, and have no malignant or with other malignant tumors. Thoracotomy was performed in6cases, video assisted thoracic surgery (VATS) was performed in2cases.2patients got massive hemorrhage in surgical resection of pulmonary lobectomy. Of these8patients,7cases were intralobar pulmonary sequestration and1was extralobar pulmonary sequestration,7patients had lesions in left lower lung and1patient in right lower lung.Anomalous artery from the systemic circulation was found at surgery in all patients:from thoracic aorta in7cases, abdominal in1ease.⑦After treatment, all of the complications relieved or disappeared. Follow-up7patients (mean8years), all of patients are survival now. None of the patients had any late or long term complications recurrent pneumonia.Conclusions①pulmonary sequestration is a relatively rare congenital malformation of the lung cysts with high misdiagnosis rate. Preoperative diagnosis of pulmonary sequestration is quite difficult. PS have the potential to undergo malignant changes or associated with pulmonary malignant neoplasm;②The clinical manifestation of PS was some kind of respiratory symptoms, which were not obvious special for diagnose. So preoperative diagnosis was difficulty, the rate of misdiagnoses and the erroneous diagnosis were high.③Contrast enhanced three-dimensional (3D) Computed Tomography is the most helpful to improve the diagnosis of PS;④have the potential to undergo Malignant changes, Surgical excision is recommended. Thoracotomy and VATS are safe and effective methods for the treatment of PS.