Video-assisted thoracoscopic surgery for pulmonary sequestration in children.
BACKGROUND
The purpose of this report is to describe our experience with video-assisted thoracoscopic surgery for pulmonary sequestration in children.


METHODS
From May 2001 to June 2004, video-assisted thoracoscopic surgery was attempted for antenatally diagnosed pulmonary sequestration in 8 consecutive infants. Mean age at the time of surgery was 10 months (range, 4 to 44 months). Six lesions were located in the left lower lobe and two in the right lower lobe. Endovascular embolization was attempted before video-assisted thoracoscopic surgery in only 1 patient. All procedures were performed in the lateral decubitus position, and single-lung ventilation was used in all cases.


RESULTS
Conversion to open surgery was necessary in two cases. Video-assisted thoracoscopic surgery was successful in 6 patients. After being identified and isolated, the aberrant artery was controlled by endoscopic ligation, and lobectomy, wedge resection, or sequestration was performed depending on the type of lesion. Mean operative time was 155 minutes. Average hospital stay was 3.5 days. There were no postoperative complications. Follow-up ranged from 4 to 50 months.


CONCLUSIONS
Video-assisted thoracoscopic surgery is technically feasible for pulmonary sequestration. Early resection obviates the risk of infection. Elective ligation of the aberrant artery is a safe alternative to the use of stapling devices or clips. Cosmetic results are excellent.
de Lagausie
Pascal
P
Department of Pediatric Surgery, Hôpital la Timone, Marseille, France. pascal.delagausie@ap-hm.fr
Bonnard
Arnaud
A
Berrebi
Dominique
D
Petit
Philippe
P
Dorgeret
Sophie
S
Guys
Jean Michel
JM
D001998:Bronchopulmonary Sequestration / Q000601:surgery*; D002675:Child, Preschool; D006801:Humans; D007902:Length of Stay; D020775:Thoracic Surgery, Video-Assisted / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome