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.