Division of Thoracic Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, ROC.
J Chin Med Assoc. 2013 Jul;76(7):385-9. doi: 10.1016/j.jcma.2013.04.002. Epub 2013 Jun 7.
Pulmonary sequestration (PS) is a rare congenital lung malformation. In this study, we evaluated the diagnosis and treatment of PS in 31 adult patients at a single institution.
A retrospective review of all patients 16 years of age and older with PS in a single institution between January 1985 and January 2011 was conducted. The following data were analyzed for all patients: major symptoms, diagnostic procedures, operative findings, operative techniques, postoperative complications, and outcome.
Our study involved 31 patients, 17 male and 14 female, with an average age of 32.1 (17-57) years, who underwent surgical intervention for PS. The preoperative symptoms of these patients included cough, hemoptysis, fever, pneumonia, and chest pain. Thirty (96.8%) patients were diagnosed by thoracic computed tomography. Of the 31 patients, 29 were diagnosed with intralobar pulmonary sequestration and two had extralobar pulmonary sequestration. Surgical procedures for intralobar pulmonary sequestration included lobectomy in 22 patients (including one thoracoscopic lobectomy), segmentectomy in six, and wedge resection in one of the patients. Thoracoscopic simple mass excision was performed on the two patients with extralobar pulmonary sequestration. Two patients had a postoperative complication (prolonged air leak in 1 patient and postoperative hemothorax in the other). The average hospital stay for all study patients was 6.4 (4-18) days, and there was no mortality.
Diagnostic tools may enable the clinician to obtain a definitive diagnosis in patients where there is a strong suspicion of PS via a noninvasive procedure. Computed tomography angiography may be the diagnostic imaging method of choice for optimal evaluation of the sequestrated lung and its vascular supply.
肺隔离症（PS）是一种罕见的先天性肺畸形。本研究评估了单一机构 31 例成人 PS 患者的诊断和治疗。
回顾性分析了 1985 年 1 月至 2011 年 1 月期间在单一机构就诊的所有年龄在 16 岁及以上的 PS 患者。对所有患者进行了以下数据分析：主要症状、诊断程序、手术发现、手术技术、术后并发症和结果。
我们的研究涉及 31 例患者，男 17 例，女 14 例，平均年龄 32.1（17-57）岁，均因 PS 行手术干预。这些患者的术前症状包括咳嗽、咯血、发热、肺炎和胸痛。30（96.8%）例患者通过胸部计算机断层扫描诊断。31 例患者中，29 例诊断为肺叶内隔离症，2 例诊断为肺叶外隔离症。肺叶内隔离症的手术方法包括 22 例患者行肺叶切除术（包括 1 例电视胸腔镜肺叶切除术）、6 例患者行肺段切除术、1 例患者行楔形切除术。对 2 例肺叶外隔离症患者行电视胸腔镜单纯肿块切除术。2 例患者术后出现并发症（1 例患者出现持续性漏气，另 1 例患者出现术后血胸）。所有研究患者的平均住院时间为 6.4（4-18）天，无死亡病例。
诊断工具可以使临床医生通过非侵入性程序对强烈怀疑 PS 的患者获得明确诊断。计算机断层血管造影术可能是评估隔离肺及其血管供应的最佳诊断影像学方法。
