ENDOSURGICAL TECHNOLOGIES FOR TREATMENT OF BRONCHOPULMONARY SEQUESTRATION IN CHILDREN

The study systematized the long-term experience of thoracoscopic and laparoscopic treatment of intra- and extrapleural forms of bronchopulmonary sequestration (BPS). Materials and methods of research: a retrospective study analysed clinical data of 20 patients with BPS who have underwent thoracoscopic and laparoscopic surgeries for 15 years, starting from 2005. The main surgical methods included thoracoscopic lobectomy, thoracoscopic sequestrectomy, laparoscopic sequestrectomy and combined thoracoscopic transdiaphragmatic access in a patient with multiple forms of BPS. Results: a total of 20 patients with BPS had an intralobar form, 5 had an extralobar form, 4 had an extrapleural type, and 1 had a combined (extralobar + extrapleural) form. Intralobar form of BPS was found in the left lower lobe in 6 patients, in the right lower lobe – in 4. Extralobar BPS was found near the left lower lobe in 3 patients, near the lower right lobe – in 2. Extrapleural BPS was observed in the abdominal cavity under the diaphragm in 3 patients, in one patient – in the thickness of the diaphragmatic muscle. One patient had a combined form of BPS in the form of an association of extralobaric and intra-abdominal types. Thoracoscopy was performed in 16 patients, laparoscopy in 4 patients. The mean operative time was 60 min (range: 40–100 min). Intraoperative blood loss was not observed. A drainage tube was installed in 10 patients with intralobaric BPS. In all other cases, the pleural and abdominal cavity was not drained. A histological examination of all resected pulmonary sequesters showed that in half of the cases (10/20) the anomaly was associated with other malformations of the lungs (cystoadenomatous malformation of the lungs, bronchogenic cyst or intestinal duplication). During the 5 year average observation period after surgery (range: 1–15 years), musculoskeletal deformities of the chest and adhesive intestinal obstruction were not recorded. Conclusion: the series of minimally invasive treatment of patients with BPS presented in this study demonstrates the effectiveness and safety of this approach, especially for the surgical correction of those forms of pulmonary sequestration when they are located in hard-to-reach anatomical spaces of the body.

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Pulmonary Tuberculosis mimicking a right Eventration on Radiography: The falsity of single view radiograph in the diagnosis of a precursor of pulmonary disease: A Case Report

Babcock University Medical Journal (BUMJ) ◽

10.38029/bumj.v4i1.65 ◽

2021 ◽

Vol 4 (1) ◽

pp. 33-37

Author(s):

John Ogunkoya ◽

Oluwatosin Yetunde Adesuyi

Keyword(s):

Pulmonary Tuberculosis ◽

Lower Lobe ◽

Middle Lobe ◽

The Body ◽

Single View ◽

Lymph Node Enlargement ◽

History Of ◽

Chest X Ray ◽

The Right ◽

High Index Of Suspicion

Background: The diaphragm is one of the most important muscles of respiration in the body separating the abdomen from the thorax. Abnormalities of the diaphragm could be congenital or acquired, morphological or functional while pulmonary infection e.g. pulmonary tuberculosis, is implicated in its etiology. Case presentation: A 63-year- old man with six weeks history of cough productive of yellowish sputum. Chest X-ray showed a uniform well-circumscribed opacity in the right lower lobe abutting on or in continuum with the right diaphragm consistent with a diaphragmatic hump. Sputum Gene Xpert was positive for Mycobacterium tuberculosis. Chest CT scan revealed bilateral lymph node enlargement with hyperdense lesions in the anterior basal segment of the right lower lobe and medial bronchopulmonary segments of the right middle lobe. He was treated for 6 months with first-line anti-tuberculosis drugs. Discussion: The incidence of the diaphragmatic hump on chest radiograph worldwide and among Nigerians is unknown. The association of diaphragmatic hump with chest infection has been well document. The association of diaphragmatic hump with pulmonary tuberculosis is uncommon. Conclusion: A high index of suspicion is needed to diagnose pulmonary tuberculosis with atypical clinical and radiological presentations. Such prompt diagnosis will aid the treatment of the disease.

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Surfactant treatments alter endogenous surfactant metabolism in rabbit lungs

Journal of Applied Physiology ◽

10.1152/jappl.1990.68.4.1590 ◽

1990 ◽

Vol 68 (4) ◽

pp. 1590-1596 ◽

Cited By ~ 21

Author(s):

S. B. Oetomo ◽

J. Lewis ◽

M. Ikegami ◽

A. H. Jobe

Keyword(s):

Lower Lobe ◽

Left Lower Lobe ◽

Exogenous Surfactant ◽

Main Stem Bronchus ◽

Label Incorporation ◽

Left Main Stem Bronchus ◽

The Right ◽

Surfactant Metabolism

The effect of exogenous surfactant on endogenous surfactant metabolism was evaluated using a single-lobe treatment strategy to compare effects of treated with untreated lung within the same rabbit. Natural rabbit surfactant, Survanta, or 0.45% NaCl was injected into the left main stem bronchus by use of a Swan-Ganz catheter. Radio-labeled palmitic acid was then given by intravascular injection at two times after surfactant treatment, and the ratios of label incorporation and secretion in the left lower lobe to label incorporation and secretion in the right lung were compared. The treatment procedure resulted in a reasonably uniform surfactant distribution and did not disrupt lobar pulmonary blood flow. Natural rabbit surfactant increased incorporation of palmitate into saturated phosphatidylcholine (Sat PC) approximately 2-fold (P less than 0.01), and secretion of labeled Sat PC increased approximately 2.5-fold in the surfactant-treated left lower lobe relative to the right lung (P less than 0.01). Although Survanta did not alter incorporation, it did increase secretion but not to the same extent as rabbit surfactant (P less than 0.01). Alteration of endogenous surfactant Sat PC metabolism in vivo by surfactant treatments was different from that which would have been predicted by previous in vitro studies.

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Comparison of anomalous systemic artery to left lower lobe and pulmonary sequestration in left lower lobe by computed tomography

Acta Radiologica ◽

10.1177/0284185114545149 ◽

2015 ◽

Vol 56 (9) ◽

pp. 1100-1104 ◽

Cited By ~ 1

Author(s):

Jie Qin ◽

Xiao-li Wang ◽

Ming-jun Bai ◽

Shao-hong Huang ◽

Xiu-zhen Chen ◽

...

Keyword(s):

Computed Tomography ◽

Lower Lobe ◽

Pulmonary Sequestration ◽

Left Lower Lobe ◽

Systemic Artery

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Coarctation of persistent right fifth aortic arch and pulmonary sequestration

Cardiology in the Young ◽

10.1017/s1047951100007198 ◽

1998 ◽

Vol 8 (4) ◽

pp. 509-511 ◽

Cited By ~ 5

Author(s):

Hideshi Tomita ◽

Shigeto Fuse ◽

Shunzo Chiba

Keyword(s):

Heart Failure ◽

Aortic Arch ◽

Subclavian Artery ◽

Balloon Dilation ◽

Lower Lobe ◽

Pressure Overload ◽

Pulmonary Sequestration ◽

Severe Congestive Heart Failure ◽

Volume Load ◽

The Right

AbstractA 41-day-old boy was transferred to our department with severe congestive heart failure. Digital subtraction counter current aortography, and antegrade aortography, revealed coarctation of a persistent right fifth aortic arch, stenosis of the origin of an aberrant left subclavian artery, and sequestration of the lower lobe of the right lung.As his heart failure seemed to be caused not only by pressure overload to the left ventricle following coarctation, but also by the volume load associated with the shunting effect of the pulmonary sequestration, we performed transcatheter balloon dilation of the coarctation and the origin of the aberrant subclavian artery, together with embolization of the aberrant pulmonary artery. His heart failure responded dramatically to these procedures.

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Anomalous systemic arterial supply to the left lower lobe without evidence of pulmonary sequestration

ANZ Journal of Surgery ◽

10.1111/ans.13440 ◽

2016 ◽

Vol 88 (5) ◽

pp. 510-510

Author(s):

Sameer Thakur ◽

Siew Simg Christine Goh ◽

Rajiv Sharma ◽

Ashutosh Hardikar

Keyword(s):

Lower Lobe ◽

Pulmonary Sequestration ◽

Left Lower Lobe ◽

Arterial Supply ◽

Systemic Arterial Supply

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OPERATION STRESS AND ITS INFLUENCE ON THE SYSTEM CHANGES IN CASE OF ABDOMINAL COMBINED TRAUMA (EXPERIMENTAL RESEARCH)

Clinical anatomy and operative surgery ◽

10.24061/1727-0847.17.2.2018.6 ◽

2018 ◽

Vol 17 (2) ◽

pp. 31-36

Author(s):

V. O. Krylyuk ◽

V. K. Hrodetsʹkyy ◽

S. O. Sokolʹnyk ◽

O. V. Fedosyeyeva ◽

H. Yu. Tsymbalyuk

Keyword(s):

Superoxide Dismutase ◽

Abdominal Cavity ◽

The Body ◽

Control Group ◽

Systemic Response ◽

Antioxidant Protection ◽

Operational Stress ◽

Experimental Animals ◽

Ischemic Reperfusion ◽

The Right

The aim of the study was to study the possibility of using a hemostatic biological haemostatic to stop bleeding from the parenchymal organs of the abdominal cavity using the surgical method of Damage control. The experiment was performed on laboratory rats that were divided into three groups: a control group, a group where, after injury, the liver wound was sutured with standard sutures and a group where the wound was plastered with a biological hemostatic agent. In order to determine the operational stress, we studied the enzymatic link of antioxidant protection - the level of catalase and superoxide dismutase. To study the indices in all experimental animals, the following tissues were taken: the lower lobe of the right lung, the proportion of the liver where the wounds were applied, the gastrocnemius muscle below the harness and the right kidney. The control points of the study were 1, 3 and 7 days after injury. During working with experimental animals, they adhered to all ethical norms established by international rules. The effect of operational stress on the enzymatic component of antioxidant protection in the tissues of the kidneys, liver, lungs and muscles was studied in the study of the combined trauma of the abdominal cavity complicated by massive bleeding and ischemic-reperfusion syndrome of the extremity. The changes in the indices of superoxide dismutase and catalase were studied. The following result was obtained: tamponing the liver wound with chitosan was a quick and effective means of temporary bleeding stop. At the same time, the duration of the operation was reduced from 19.8 to 12.5 minutes (by 36.8%) (p <0.05). Also, the level of catalase and superoxide dismutase was significantly lower in the group where the chitosan of the liver injury was used in comparison with the study group where standard stitches were applied. The deviations, which are determined in lung, liver, kidney and muscle tissues in RG-1 are evidence of the depth of their lesion and dysfunction, is a favorable factor for the further development of the triggering mechanisms of the systemic response of the body to inflammation and multiple organ failure. In contrast to the RG-2 rapid development of the systemic response was avoided. We can assume that ischemic-reperfusion syndrome is a stimulating factor in the development of systemic changes, although this statement requires further proof. It is also important to further prospective study of this topic in terms of the following questions: what effect has chitosan on liver tissue with prolonged exposure (more than 2 days) and what effect does additional injection of infusion solutions have as an agent for the treatment of hypovolemic shock.

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Intralobar pulmonary sequestrations in adults

Journal of Clinical Review & Case Reports ◽

10.33140/jcrc/02/01/00002 ◽

2017 ◽

Vol 2 (1) ◽

Keyword(s):

Lower Lobe ◽

Pulmonary Sequestration ◽

Military Hospital ◽

Lateral Side ◽

Intralobar Sequestration ◽

Arterial Blood ◽

Systemic Artery ◽

Clinical Presentations ◽

Chest X Ray ◽

The Right

Intralobar sequestration accounts for 75% of pulmonary sequestrations. It is characterized by the presence of nonfunctional parenchymal lung tissue, receiving systemic arterial blood supply. We conducted a retrospective medical records review of all patients evaluated and treated in our pulmonary department of military hospital of Tunisia with diagnosis of PS from January 2007 through December 2015. Among them, we report 5 cases of intralobar pulmonary sequestrations operated. There are three women and two men; the mean age is 27.6 years. The sequestration was intralobar in all cases. Clinical presentations were chest pain and productive cough in three cases. Chest X-ray showed left basal opacity in three cases, bilateral basal reticulonodular opacities in one case and round hydric opacity in the right lower lobe in one other case. Computed tomography was performed and revealed an aberrant systemic artery born from the lateral side of aorta supplying a left lower lobe sequestration in four cases and a right lower lobe mass in only one case. The confirmation was operative in all cases and histologic only in three cases. All patients were treated by lobectomy. Only one case presented with a pulmonary sequestration combined with tuberculosis and he was treated firstly by antituberculous chemotherapy. The results were excellent with a favorable clinical course and the mortality was nil.

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Breathing frequency responses to pulmonary CO2 in an isolated lobe of the canine lung

Journal of Applied Physiology ◽

10.1152/jappl.1979.47.6.1201 ◽

1979 ◽

Vol 47 (6) ◽

pp. 1201-1206 ◽

Cited By ~ 5

Author(s):

J. O. Nilsestuen ◽

R. L. Coon ◽

F. O. Igler ◽

E. J. Zuperku ◽

J. P. Kampine

Keyword(s):

Airway Pressure ◽

Left Lung ◽

Lower Lobe ◽

Stretch Receptor ◽

Left Lower Lobe ◽

Breathing Frequency ◽

Frequency Responses ◽

Mechanical Effects ◽

Frequency Changes ◽

The Right

Recent studies have indicated that the breathing frequency responses to inspired CO2 in part result from changes in pulmonary stretch receptor activity. Pulmonary CO2 may alter frequency by direct inhibition of stretch receptor discharge, or secondarily, by changes in airway mechanics. The vascularly isolated left lower lobe (LLL) of the canine lung was used to determine the effect of hypocapnic airway constriction on the pulmonary CO2 reflex. The upper and middle lobes of the left lung were removed and the right vagus nerve sectioned. Blood was recirculated through the LLL. Diaphragm electromyogram was used as an index of respiratory center activity and to trigger ventilation of the left lower lobe. Lobar hypocapnia increased peak airway pressure and reduced respiratory rate. However, infusion of isoproterenol or the use of a mechanical overflow system to block the airway pressure response prevented the frequency changes associated with CO2. Although both the direct and mechanical effects of CO2 on stretch receptors may contribute to the reflex, in the LLL preparation the mechanical effects predominate.

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