Hongchun
Guangdong Women and Children Hospital and Health Institute, China
Title: Management for intradiaphragmatic extralobar pulmonary sequestration-Pediatric thoracoscope surgery postnatal and prognosis
Biography
Biography: Hongchun
Abstract
Abstract
Here we report the largest series of patients with IDEPSs in all bronchopulmonary sequestration cases from March 2011 to Sep 2015 (17cases) and analysis of the surgical treatment.
Purpose: To evaluate the surgical management of intradiaphragmatic extralobar pulmonary sequestration (IDEPS): Complete video-assisted thoracoscopic surgery (cVATS), video-assisted mini-thoracotomy surgery (VAMT) and thoracotomy.
Methods: We retrospectively reviewed cases of bronchopulmonary sequestrations (BPS) diagnosed in our hospital from March 2011 to Sep 2015, in order to identify patients with IDEPS. Diagnosis of IDEPS was confirmed using prenatal doppler ultrasound, postnatal intravascular enhanced computed tomography, and surgery. Experience of surgical treatment was summarized by comparing the cVATS, VAMT and thoracotomy.
Results: The 17 cases diagnosed with IDEPSs were confirmed with histopathology. In our first case, we did not find any mass from abdominal surgery, and then we turned to transthoracic surgery. 6 patients underwent thoracotomy, and 6 cases underwent cVATS; 4 cases underwent VAMT. All surgeries succeeded. MRI prenatal showed a homogeneous mass (2.72 x 2.38 x 4.24 cm) between the diaphragm and the left kidney. It demonstrated high signal intensity on FIESTA and low signal intensity on FIRM. The margin of mass was still clearly defined. Flow empty phenomena were detected. The left adrenal gland was compressed and displaced downward. CT postnatal showed the mass behind the liver, upon the kidney.
Conclusions: IDEPS is a rare type in BPS. It would be better to approach through the chest. Thoracoscopy is safe and effective by experienced surgeon.