Surgical approach in pulmonary sequestrations: An institutional experience with 32 cases

Background: This study aims to present our experiences on surgical treatment of pulmonary sequestrations. Methods: A total of 32 patients (16 males, 16 females; mean age 32.7 +/- 13.4 years; range 4 to 61 years) who were performed surgical resection for pulmonary sequestration between January 1987 and December 2015 were reviewed. Patients were evaluated according to demographics, symptoms, diagnostic methods, type, localization and vascular characteristics of pulmonary sequestration, type of resection, complications, and outcomes. Results: Of the patients, intralobar sequestration was detected in 87.5% and extralobar sequestration in 12.5%. Intralobar sequestration was located in the lower lobe in 89.3% and in the upper lobe in 10.7% of the patients. All extralobar sequestrations were located in the left hemithorax; 75% was located at the base of the hemithorax and 25% was located at the apex. Of the patients, lobectomy was performed in 53.1%, wedge resection in 25%, mass excision in 12.5%, and segmentectomy in 9.4%. Postoperative complications occurred in 18.8% of the patients as prolonged air leak in three patients, wound infection in two patients, and empyema in one patient. No mortality was observed. Median follow-up period was 42 months (range 3 to 105 months) and we detected that patients remained asymptomatic. Conclusion: Although pulmonary sequestration has a benign course, it should be removed owing to its severe complications even if patients are asymptomatic. Computed tomographic angiography is a good diagnostic tool for pulmonary sequestrations.