Intralobar sequestration associated with cystic adenomatoid malformation: diagnostic and thoracoscopic pitfalls

Background Intralobar sequestration (ILS) associated with congenital cystic adenomatoid malformation (CCAM) is a well-known entity. This hybrid form has many considerations for an appropriate management. This report aims to analyze pitfalls in the diagnosis, treatment, and thoracoscopic procedure pe...

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Veröffentlicht in:Surgical endoscopy 2009-08, Vol.23 (8), p.1750-1753
Hauptverfasser: Zeidan, Smart, Hery, Geraldine, Lacroix, Ferderic, Gorincour, Guillaume, Potier, Alain, Dubus, Jean Christophe, Guys, Jean-Michel, de Lagausie, Pascal
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container_end_page 1753
container_issue 8
container_start_page 1750
container_title Surgical endoscopy
container_volume 23
creator Zeidan, Smart
Hery, Geraldine
Lacroix, Ferderic
Gorincour, Guillaume
Potier, Alain
Dubus, Jean Christophe
Guys, Jean-Michel
de Lagausie, Pascal
description Background Intralobar sequestration (ILS) associated with congenital cystic adenomatoid malformation (CCAM) is a well-known entity. This hybrid form has many considerations for an appropriate management. This report aims to analyze pitfalls in the diagnosis, treatment, and thoracoscopic procedure pertaining to this association. Methods Between May 2004 and September 2007, 23 fetal lung lesions were diagnosed prenatally and managed at the authors’ institution. Seven of these lesions were the hybrid form of ILS-CCAM. The records for these lesions were reviewed retrospectively. Results In all seven fetuses, prenatal ultrasound diagnosed congenital lung abnormalities. In three cases, fetal magnetic resonance imaging (MRI) demonstrated a macrocystic lesion supplied by an aberrant vessel. In all cases, the intrauterine evolution remained uncomplicated. All the newborns were asymptomatic at birth. Chest computed tomography (CT) performed at the age of 1 month showed the aberrant vessel in five cases. A regression of the lesion was noted in one patient and that of the aberrant vessel in another patient. Elective thoracoscopic lobectomy of the affected lobe was performed for six patients. The average age at the time of intervention was 5 months. At this writing, one patient is under observation due to resolution of the lesion. The operating time ranged from 80 to 160 min. One conversion to thoracotomy was required. All surgically treated patients had an uneventful hospital course. Histopathologic examination confirmed the association of intralobar sequestration with Stocker type 2 CCAM in five cases and with CCAM type 1 in one case. Conclusions Prenatal diagnosis of the ILS-CCAM association was possible, as was resolution of one or both components of this lesion. Preoperative identification of the aberrant vessel is important for prevention of operative morbidity. This should be controlled before the lobectomy is begun.
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This hybrid form has many considerations for an appropriate management. This report aims to analyze pitfalls in the diagnosis, treatment, and thoracoscopic procedure pertaining to this association. Methods Between May 2004 and September 2007, 23 fetal lung lesions were diagnosed prenatally and managed at the authors’ institution. Seven of these lesions were the hybrid form of ILS-CCAM. The records for these lesions were reviewed retrospectively. Results In all seven fetuses, prenatal ultrasound diagnosed congenital lung abnormalities. In three cases, fetal magnetic resonance imaging (MRI) demonstrated a macrocystic lesion supplied by an aberrant vessel. In all cases, the intrauterine evolution remained uncomplicated. All the newborns were asymptomatic at birth. Chest computed tomography (CT) performed at the age of 1 month showed the aberrant vessel in five cases. A regression of the lesion was noted in one patient and that of the aberrant vessel in another patient. Elective thoracoscopic lobectomy of the affected lobe was performed for six patients. The average age at the time of intervention was 5 months. At this writing, one patient is under observation due to resolution of the lesion. The operating time ranged from 80 to 160 min. One conversion to thoracotomy was required. All surgically treated patients had an uneventful hospital course. Histopathologic examination confirmed the association of intralobar sequestration with Stocker type 2 CCAM in five cases and with CCAM type 1 in one case. Conclusions Prenatal diagnosis of the ILS-CCAM association was possible, as was resolution of one or both components of this lesion. Preoperative identification of the aberrant vessel is important for prevention of operative morbidity. This should be controlled before the lobectomy is begun.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-008-0183-7</identifier><identifier>PMID: 18855054</identifier><identifier>CODEN: SUREEX</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>Abdominal Surgery ; Asymptomatic ; Biological and medical sciences ; Blood Vessels - abnormalities ; Bronchopulmonary Sequestration - diagnostic imaging ; Bronchopulmonary Sequestration - embryology ; Bronchopulmonary Sequestration - etiology ; Bronchopulmonary Sequestration - surgery ; Bronchoscopy ; Cystic Adenomatoid Malformation of Lung, Congenital - complications ; Cystic Adenomatoid Malformation of Lung, Congenital - diagnostic imaging ; Cystic Adenomatoid Malformation of Lung, Congenital - embryology ; Cystic Adenomatoid Malformation of Lung, Congenital - surgery ; Endoscopy ; Female ; Fetuses ; Gastroenterology ; General aspects ; Gestational Age ; Gynecology ; Hepatology ; Histology ; Humans ; Infant, Newborn ; Investigative techniques, diagnostic techniques (general aspects) ; Ligation ; Lung - blood supply ; Magnetic Resonance Imaging ; Male ; Medical sciences ; Medicine ; Medicine &amp; Public Health ; Newborn babies ; Ostomy ; Patients ; Proctology ; Retrospective Studies ; Surgery ; Thoracic surgery ; Thoracoscopy - methods ; Tomography ; Ultrasonic imaging ; Ultrasonography, Prenatal</subject><ispartof>Surgical endoscopy, 2009-08, Vol.23 (8), p.1750-1753</ispartof><rights>Springer Science+Business Media, LLC 2008</rights><rights>2009 INIST-CNRS</rights><rights>Springer Science+Business Media, LLC 2009</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c399t-8eba6cc4d913f9a1728f10c8f67c42bb03af6a59d92478b6cd853e943a0676603</citedby><cites>FETCH-LOGICAL-c399t-8eba6cc4d913f9a1728f10c8f67c42bb03af6a59d92478b6cd853e943a0676603</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-008-0183-7$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-008-0183-7$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27922,27923,41486,42555,51317</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=21798814$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18855054$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zeidan, Smart</creatorcontrib><creatorcontrib>Hery, Geraldine</creatorcontrib><creatorcontrib>Lacroix, Ferderic</creatorcontrib><creatorcontrib>Gorincour, Guillaume</creatorcontrib><creatorcontrib>Potier, Alain</creatorcontrib><creatorcontrib>Dubus, Jean Christophe</creatorcontrib><creatorcontrib>Guys, Jean-Michel</creatorcontrib><creatorcontrib>de Lagausie, Pascal</creatorcontrib><title>Intralobar sequestration associated with cystic adenomatoid malformation: diagnostic and thoracoscopic pitfalls</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Background Intralobar sequestration (ILS) associated with congenital cystic adenomatoid malformation (CCAM) is a well-known entity. This hybrid form has many considerations for an appropriate management. This report aims to analyze pitfalls in the diagnosis, treatment, and thoracoscopic procedure pertaining to this association. Methods Between May 2004 and September 2007, 23 fetal lung lesions were diagnosed prenatally and managed at the authors’ institution. Seven of these lesions were the hybrid form of ILS-CCAM. The records for these lesions were reviewed retrospectively. Results In all seven fetuses, prenatal ultrasound diagnosed congenital lung abnormalities. In three cases, fetal magnetic resonance imaging (MRI) demonstrated a macrocystic lesion supplied by an aberrant vessel. In all cases, the intrauterine evolution remained uncomplicated. All the newborns were asymptomatic at birth. Chest computed tomography (CT) performed at the age of 1 month showed the aberrant vessel in five cases. A regression of the lesion was noted in one patient and that of the aberrant vessel in another patient. 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Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zeidan, Smart</au><au>Hery, Geraldine</au><au>Lacroix, Ferderic</au><au>Gorincour, Guillaume</au><au>Potier, Alain</au><au>Dubus, Jean Christophe</au><au>Guys, Jean-Michel</au><au>de Lagausie, Pascal</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intralobar sequestration associated with cystic adenomatoid malformation: diagnostic and thoracoscopic pitfalls</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2009-08-01</date><risdate>2009</risdate><volume>23</volume><issue>8</issue><spage>1750</spage><epage>1753</epage><pages>1750-1753</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><coden>SUREEX</coden><abstract>Background Intralobar sequestration (ILS) associated with congenital cystic adenomatoid malformation (CCAM) is a well-known entity. This hybrid form has many considerations for an appropriate management. This report aims to analyze pitfalls in the diagnosis, treatment, and thoracoscopic procedure pertaining to this association. Methods Between May 2004 and September 2007, 23 fetal lung lesions were diagnosed prenatally and managed at the authors’ institution. Seven of these lesions were the hybrid form of ILS-CCAM. The records for these lesions were reviewed retrospectively. Results In all seven fetuses, prenatal ultrasound diagnosed congenital lung abnormalities. In three cases, fetal magnetic resonance imaging (MRI) demonstrated a macrocystic lesion supplied by an aberrant vessel. In all cases, the intrauterine evolution remained uncomplicated. All the newborns were asymptomatic at birth. Chest computed tomography (CT) performed at the age of 1 month showed the aberrant vessel in five cases. A regression of the lesion was noted in one patient and that of the aberrant vessel in another patient. Elective thoracoscopic lobectomy of the affected lobe was performed for six patients. The average age at the time of intervention was 5 months. At this writing, one patient is under observation due to resolution of the lesion. The operating time ranged from 80 to 160 min. One conversion to thoracotomy was required. All surgically treated patients had an uneventful hospital course. Histopathologic examination confirmed the association of intralobar sequestration with Stocker type 2 CCAM in five cases and with CCAM type 1 in one case. Conclusions Prenatal diagnosis of the ILS-CCAM association was possible, as was resolution of one or both components of this lesion. Preoperative identification of the aberrant vessel is important for prevention of operative morbidity. This should be controlled before the lobectomy is begun.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>18855054</pmid><doi>10.1007/s00464-008-0183-7</doi><tpages>4</tpages></addata></record>
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subjects Abdominal Surgery
Asymptomatic
Biological and medical sciences
Blood Vessels - abnormalities
Bronchopulmonary Sequestration - diagnostic imaging
Bronchopulmonary Sequestration - embryology
Bronchopulmonary Sequestration - etiology
Bronchopulmonary Sequestration - surgery
Bronchoscopy
Cystic Adenomatoid Malformation of Lung, Congenital - complications
Cystic Adenomatoid Malformation of Lung, Congenital - diagnostic imaging
Cystic Adenomatoid Malformation of Lung, Congenital - embryology
Cystic Adenomatoid Malformation of Lung, Congenital - surgery
Endoscopy
Female
Fetuses
Gastroenterology
General aspects
Gestational Age
Gynecology
Hepatology
Histology
Humans
Infant, Newborn
Investigative techniques, diagnostic techniques (general aspects)
Ligation
Lung - blood supply
Magnetic Resonance Imaging
Male
Medical sciences
Medicine
Medicine & Public Health
Newborn babies
Ostomy
Patients
Proctology
Retrospective Studies
Surgery
Thoracic surgery
Thoracoscopy - methods
Tomography
Ultrasonic imaging
Ultrasonography, Prenatal
title Intralobar sequestration associated with cystic adenomatoid malformation: diagnostic and thoracoscopic pitfalls
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