Treatment of pulmonary sequestration in children Surgical resection versus endovascular embolization

Abstract

Introduction: Pulmonary sequestration is a lower respiratory malformation of the tract, which consists of a nonfunctional mass of lung tissue without communication with the tracheobronchial tree and the blood supply coming from one or more aberrant systemic arteries.

Objective: to analyze outcomes of pediatric patients with pulmonary sequestration treated with surgical resection (thoracotomy, video-assisted thoracoscopy) or endovascular embolization.

Methods: descriptive, observational, retrospective, cross-sectional study, in a tertiary pediatric hospital in Ecuador, from January 2017 to December 2022. Data was collected from chart review.

Results: 9 patients under the age of 18 were included, with a diagnosis of pulmonary sequestration, 6 females and 3 males, 5 were treated with surgery, 4 (44%) by thoracotomy and 1 (11%) by video-assisted thoracoscopy, 4 (44%) with endovascular embolization, the mean age of patients who underwent surgery was 41.36 months (range: 0.1-144 months), and of those who underwent embolization was 12.9 months (range: 0.6-41 months). One patient died 6 days after the surgical resection of the pulmonary sequestration by thoracotomy secondary to pulmonary hypertension due to his underlying heart disease, and 1 patient treated with endovascular embolization developed decrease in pedal pulse, which resolved 24 hours after starting streptokinase.

Conclusion: As far as we have investigated, there is not anotherther publication in our country where two therapeutic methods are compared for the treatment of pulmonary sequestration, in this study both surgery and endovascular embolization were safe procedures, however, no significant differences were found between both treatment options, more prospective studies are needed that include a large population sample in patients treated by endovascular embolization.