Video-Assisted Thoracic Surgery for a case of bronchopulmonary sequestration
Posted in Pictures on 14 January 2015
Published by Borja de Lacy
Laureano Molins (Chief of the Thoracic Surgery Department)
Juan J Fibla (Thoracic Surgery Specialist)
Jorge Hernández (Thoracic Surgery Specialist)
Hospital Clínic, Barcelona – Spain
A 28 year old man, smoker, who has been monitored since 2008 due to casual finding of bronchopulmonary sequestration in the left inferior lobe, with no symptoms.
In November 2013 he started to complain about cough and expectoration. A CT-Scan was ordered, and revealed the known intralobar bronchopulmonary sequestration in left inferior lobe associated to cystic images, one of them probably infected (FIG. 1).
Physical examination did not show any pathological features, including normal cardiorespiratory auscultation and absence of palpable lymph nodes. Pulmonary function tests were performed, indicating a FVC of 5.28L (97%), a FEV1 of 4.14L (95%), and IT was 98%.
Surgical treatment was accomplished by Video-Assisted Thoracic Surgery (VATS) to improve visualization and diminish the aggression to the thoracic wall (FIG. 2). Left inferior lobule showed pathologic features, and an arterial supply from the thoracic aorta to the posterior inferior segment was identified and transected with a vascular EndoStapler (FIG. 3 and FIG. 4). Left inferior lobectomy was completed with no intraoperative complications, and a thoracic drainage was placed.
No immediate postoperative complications were observed, and drainage was removed 2 days later. Patient was discharged 4 days after surgery, and currently he is completely asymptomatic.