Prenatal interventional and postnatal surgical therapy of extralobar pulmonary sequestration

Abstract

Extralobar sequestration, a discrete developmental mass of pulmonary parenchyma which is enclosed within a separate pleural envelope and has its own vascular supply, is recently diagnosed prenatally by ultrasonography. We report two male newborn babies, 10 days old, who prenatally underwent amnioperitoneal shunt, pleural drainage and laser ablation of the feeding artery. Both babies underwent thoracotomy on their 10th day of life, removal of the sequestration, ligation of the feeding vessel which remained patent despite laser treatment in the first case and drainage of a large pleural effusion in the second case. Both babies had an uncomplicated course and are well 80 and 48 months after surgery, respectively. Extralobar sequestration should undergo operation as early as possible after birth, even after prenatal laser ablation of the feeding artery, since mortality and morbidity of surgery are extremely low, while newborns are protected from future infections.