Two cases of thoracoscopic removal of pulmonary sequestration due to thick, anomalous artery: Focus on how to process anomalous arteries that are horizontal

Abstract

We evaluated the treatment method for large anomalous arteries and the stumps thereof in cases with intralobar pulmonary sequestration of the left and right lower lung lobes, in which lower lobectomy under thoracoscopy was carried out with favorable outcomes. [Case 1] A 54-year-old male. An anomalous artery was observed diverging from the descending aorta of the chest and flowing into the right lower lung lobe. It was diagnosed as intralobar pulmonary sequestration of the right lower lung lobe, and a VATS lobectomy of the right lower lung lobe was carried out. The anomalous artery, with a diameter of 18 mm, was exfoliated to the lower aorta and ligated from the center using vessel tapes, No. 2 silk thread, and No. 1 silk thread, in that order, after which the peripheral part was separated using an automatic suture device. [Case 2] A 27-year-old male. A VATS lobectomy of the left lower lung lobe was carried out for intralobar pulmonary sequestration of the left lower lung lobe. An anomalous artery, with a diameter of 13 mm, flowing into the left basal segment from the descending aorta of the chest near the diaphragm was treated in the same way as in Case 1. The post-operative dynamic CT indicated no signs of stump swelling of the anomalous artery stumps in either case. The treatment of anomalous arteries at our hospital involves double ligature and the use of an automatic suture device, which we believe guarantees safety and reliability.