Undiagnosed pulmonary sequestration results in an unexplained hemorrhagic shock in thoracoscopic pulmonary lobectomy

Li, Rui; Li, Huiping; Liang, Tao; Wu, Cong

doi:10.1016/j.jclinane.2016.09.018

Cited by 5 publications

(4 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Identification and control of the systemic artery were regarded as the most crucial steps in the operation of pulmonary sequestration. Failure to control the systemic artery, especially when it derives from the abdominal aorta, may lead to disastrous results (12). The aberrant systemic artery was usually located within the pulmonary ligament and embedded in thickened adhesive tissue after repeated pulmonary infection.…”

Section: Discussionmentioning

confidence: 99%

Uniportal video-assisted thoracoscopic surgery lobectomy and segmentectomy for pulmonary sequestration

et al. 2018

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Uniportal video-assisted thoracoscopic surgery lobectomy and segmentectomy for pulmonary sequestration

et al. 2018

View full text Add to dashboard Cite

show abstract

“…The safety of end-staplers for arterial procedures was not confirmed until 2004, so stapling division was planned after proximal ligation of the aberrant artery using 2-0 silk. 3 In surgery, tension on the vessel during proximal ligation using a knot pusher led to injury at the branching point from the lower thoracic aorta. Fortunately, hemostasis was achieved by maintaining pressure on the bleeding point throughout the whole lung with Narke Type Thoraco-Cotton (Kenzmedic co, Saitama, Japan), without needing conversion to thoracotomy.…”

Section: Resultsmentioning

confidence: 99%

Surgical strategy for pulmonary sequestration: Focus on precautions for aberrant vessels under minimally invasive surgery

Nakagawa

Wada

Aruga

et al. 2021

Proceedings of Singapore Healthcare

View full text Add to dashboard Cite

Background Recently, thoracoscopic resection of pulmonary sequestration has become more common, since resection of an aberrant artery using an end-stapler is a safe maneuver in many cases. However, injury of the vessels can lead to major hemorrhage. We reported our surgical experience based on thoracoscopic surgery, with five cases of interlobar pulmonary sequestration, focusing on precautions for aberrant arterial vessels. Object and methods We performed pulmonary resections for five patients with interlobar pulmonary sequestration in a lower lobe (left, n = 4; right, n = 1) between April 2004 and May 2020. All aberrant vessels were derived from the lower thoracic artery. Two patients had a single aberrant artery and three had multiple. In four patients, these vessels were detected before surgery, and pulmonary sequestration was diagnosed in four. In one elderly patient, the aberrant vessel was overlooked, and lung cancer was suspected before surgery. Angiography or multidetector-row computed tomography was subsequently performed in four cases. The surgical plan was determined according to the location and size of the pulmonary lesion and three-dimensional images of aberrant vessels. Result In all patients, approaches were made thoracoscopically. Hemorrhage from an anomalous vessel was encountered in one case. Pulmonary resections included two lobectomies and three limited resections. Angioplasty for the root of anomalous branches was performed following pulmonary resections under converted minimal lateral thoracotomy in two cases. Conclusion Preoperative assessment of the anatomical variations in abnormal vessels is essential to achieve safe surgical procedures. According to the situation of the aberrant vessels, selecting surgical procedures with consideration of potential subsequent complications arising over a long period of time is important.

show abstract

“…The surgical management of PS by VATS is accepted worldwide and is superior to the thoracotomy approach [ 6 , 7 ] in terms of postoperative outcome, hospital stay and postoperative pain. There are still some concerns about the management of haemorrhage following VATS in case of rupture of the aberrant vessel during dissection manoeuvres [ 3 ]. Therefore, we consider it reasonable to perform preoperative endovascular embolization of large aberrant vessel to obtain the aberrant systemic vessel’s occlusion, which may be friable due to chronic inflammation, with the aim to prevent potentially life-threatening intraoperative bleeding in course of surgery for major pulmonary resection [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…Surgical resection is generally recommended in order to prevent ischaemic and infectious complications [ 1 , 2 ]. However, despite the recent increase in the application of the thoracoscopic approach [video-assisted thoracoscopic surgery (VATS)] in lung surgery, there are still some concerns about the use of minimally invasive techniques for ILPS due to the risk of haemorrhage caused by incidental injury of the fragile aberrant artery wall and its retraction deep into the mediastinum or into the abdomen [ 3 ] during surgical manipulation. Although there have been several reports of the use of vascular plugs to exclude ILPS, mostly in paediatric patients [ 4 ], to the best of our knowledge there are only 2 reports in the literature about a hybrid sequential approach involving atypical lung resection [ 2 ], but none followed by major pulmonary resection.…”

Section: Introductionmentioning

confidence: 99%

Hybrid minimally invasive treatment of intralobar pulmonary sequestration: a single-centre experience

Grossi

Londero

Vit

et al. 2021

Interactive CardioVascular and Thoracic Surgery

View full text Add to dashboard Cite

Pulmonary sequestrations are rare congenital malformations. They are often located in the lower lobes, and they are supplied by an aberrant systemic vessel arising from the thoracic aorta or abdominal arteries. These pulmonary malformations are divided into intra- and extralobar sequestrations, depending on the respective lack or presence of an independent pleural covering. Pulmonary sequestration can be asymptomatic or lead to recurrent pulmonary infections. The goal of this study was to analyse the feasibility and safety of a hybrid sequential approach. We report a small series of intralobar pulmonary sequestrations, from November 2017 to December 2018, successfully treated with a hybrid minimally invasive approach consisting of endovascular embolization of the aberrant arterial branch followed by video-assisted thoracoscopic lobectomy the day after. Thoracic pain following endovascular embolization was noted in all cases. Patients were discharged early in the absence of major postoperative complications. Prolonged air leak was observed in only 1 case. Despite the presence of sequestration-related pulmonary inflammation, in our experience, hybrid treatment for intralobar pulmonary sequestration is a safe and reproducible approach in terms of postoperative complications and hospital stay.

show abstract

Undiagnosed pulmonary sequestration results in an unexplained hemorrhagic shock in thoracoscopic pulmonary lobectomy

Cited by 5 publications

References 9 publications

Uniportal video-assisted thoracoscopic surgery lobectomy and segmentectomy for pulmonary sequestration

Uniportal video-assisted thoracoscopic surgery lobectomy and segmentectomy for pulmonary sequestration

Surgical strategy for pulmonary sequestration: Focus on precautions for aberrant vessels under minimally invasive surgery

Hybrid minimally invasive treatment of intralobar pulmonary sequestration: a single-centre experience

Contact Info

Product

Resources

About