Pulmonary sequestration; is non-functioning rigid lung tissue without regular tracheobronchial and vascular connections.
Most of these pulmonary sequestrations are located inside and outside the lung. Recurrent pneumonia and respiratory distress due to compression of large lesions are common. The lesion's arterial supply comes directly from the aorta.
If it is accidentally injured during the surgery, there will be a lot of bleeding. It is most common in the left lower posterior basal lobe. For fetal diagnosis, we use ultrasonography (USG). Color Doppler USG can detect systemic arterial circulation.
An MRI examination can confirm the diagnosis. The diagnosis is possible in the neonatal period by chest X-ray and Doppler USG. The diagnosis of older children is possible with PA chest X-ray, contrast-enhanced chest CT, and MRI.
Treatment of Pulmonary Sequestration
In treating pulmonary sequestration, if the baby has no severe problem, we prefer to perform the surgery one year later.
Here we prefer closed surgery methods (Thoracoscopic Surgery/VATS). With the development of technology, we prefer closed surgeries even for children aged 8-12 months.
With the development of technology, we prefer closed surgeries even for children aged 8-12 months. We perform closed surgery methods through one or two incisions; in contrast to open surgery, we do not place an intercostal retractor. One of these incisions is 1 cm, and the other is a two or 3-cm incision. Closed surgical instruments are advanced through these incisions. We remove the diseased area. Closed surgeries have many advantages, such as; less pain, shorter recovery time, and aesthetic incision scar. Even a tiny incision causes huge scars in open surgery.
Patients generally stay in the intensive care unit for one day and discharge within 3-4 days. Closed surgeries require special high-tech devices and a highly experienced center.