Clinical study on risk factors and surgical results of pulmonary sequestration in adults
YANG Weiguang
YI Chengxiang
ZHANG Peng
DAI Jie
Abstract：Objective To investigate the risk factors of preoperative diagnosis and postoperative complications of pulmonary sequestration(PS).Methods A retrospective analysis was performed on adult patients who received surgical treatment for PS in Shanghai Pulmonary Hospital from June 2013 to December 2022.Logistic regression analysis was applied to identify risk factors for preoperative diagnosis and postoperative complications of PS.Results A total of 97 patients were included,the preoperative misdiagnosis rate was 38.1％(37/97),and the most common misdiagnosed disease was lung tumor/nodule(23/37,62.2％).Nearly 59.0％of PS patients also had a history of recurrent respiratory infections or persistent infections at a fixed location in the left lower lung.Asymptomatic presentation,solid mass,and extralobar sequestration(ELS)were independent risk factors for preoperative diagnosis of PS.Compared with the preoperative confirmed group,the operation time(120.8 min vs 109.0 min,P=0.038),intraoperative blood loss(196.5 mL vs 108.3 mL,P=0.005),and postoperative complications(21.6％vs 5.0％,P=0.019)were significantly increased in the misdiagnosis group.The postoperative complication rate was 11.3％(11/97),including 4 cases of transfusions,3 cases of pneumonia,3 cases of arrhythmias,and 1 case of air leakage.Multivariate logistic regression analysis showed that preoperative misdiagnosis and thoracotomy were independent risk factors for postoperative complications of PS.Conclusion Asymptomatic presentation,solid mass,and ELS are independent risk factors for preoperative diagnosis of PS patients.Preoperative misdiagnosis and thoracotomy are independent risk factors for postoperative complications in PS.Clinicians should highly suspect PS when diagnosing asymptomatic solid masses near the spine in the lower lobes of the lung,especially if the patient has a history of recurrent respiratory infections or persistent infections at a fixed location in the left lower lung.Preoperative use of contrast examination to identify abnormal arteries is recommended to confirm the diagnosis.Minimally invasive surgery is a safe and effective treatment for PS.
Keywords：pulmonary sequestrationpreoperative diagnosispostoperative complicationsrisk factorsthoracoscopic surgery
Publication Date：2024-10-28
Online Publishing Date：2026-08-26(First online date of this platform, not the publication date of the document)
Pages：7( 1178-1183,1190 )