Pulmonary sequestration in adult patients: a retrospective study

OBJECTIVES: Pulmonary sequestration (PS) is a rare congenital malformation. This study presents the characteristics of PS in adult patients, including pulmonary function and concurrent infection, which have not been well documented previously. METHODS: Patients ≥16 years old with a discharge diagnosis of PS from Peking Union Medical College Hospital between January 1990 and December 2013 were retrospectively analysed. Age, sex, clinical symptoms, chest computed tomography (CT) results, results of pul-monary function tests, diagnostic methods, type and localization of sequestration, origin of arterial supply, complications due to infection and treatment information were retrieved from hospital records and analysed. RESULTS: Seventy-two patients were included in this study (mean age 36.6 ± 11.8 years). Clinical symptoms included cough, expectoration, haemoptysis, intermittent fever and chest pain. The most common CT findings were soft tissue opacity, cystic lesion, cavitary lesion and bronchiectasis. Intralobar and extralobar sequestrations were present in 92.8 and 7.2 % of the patients, respectively. PS located in the left lower lobe was 2.1 times more frequent than that in the right lower lobe. PS was diagnosed by computed tomography angiography (CTA) in only 37.5 % of patients; the remaining patients were undiagnosed before surgery. Obstructive ventilation dysfunction was found in 8.8% of patients. Pulmonary aspergillosis was detected in 9.7 % of patients, and Pseudomonas aeruginosa was the leading pathogen (as deter-mined by tissue cultures). PS was resected via thoracotomy in 87.0 % of patients and via video-assisted thoracoscopic surgery (VATS) in 13.0%