Research: Thoracoscopic repair of neonatal left diaphragmatic hernia with sac combined with both extralobar pulmonary sequestration and congenital pulmonary airway malformation

Asian J Endosc Surg

. 2022 Aug 19.

 doi: 10.1111/ases.13120. Online ahead of print. https://pubmed.ncbi.nlm.nih.gov/35983859/

Thoracoscopic repair of neonatal left diaphragmatic hernia with sac combined with both extralobar pulmonary sequestration and congenital pulmonary airway malformation

Koji Yamada 1Mitsuru Muto 1Shun Onishi 1Seiro Machigashira 2Nanako Nishida 1Ayaka Nagano 1Masakazu Murakami 1Koshiro Sugita 1Keisuke Yano 1Toshio Harumatsu 1Waka Yamada 1 3Makoto Matsukubo 1Takafumi Kawano 1Satoshi Ieiri 1

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Abstract

Intradiaphragmatic extralobar pulmonary sequestration (IDEPS) is considered to be very rare among extralobar pulmonary sequestration (EPS), and IDEPS combined with congenital diaphragmatic hernia (CDH) with sac is extremely rare. The patient was a neonatal girl. Left-sided CDH with a hernia sac was diagnosed based on computed tomography (CT). Thoracoscopic repair was planned for the 5th day after birth. Left CDH with sac was recognized on the posterolateral side and isolated EPS was recognized on the sac. The hernia sac, including the EPS, was resected, and the diaphragm defect was closed. The resected specimen consisted of fibrous connective tissue and pulmonary sequestration (PS) connected with the sac. It was diagnosed as the hybrid form, with features of both type 2 congenital pulmonary airway malformation (CPAM) and EPS. The postoperative course was uneventful. At 1 year and 9 mo after the operation, no recurrence of herniation or laterality of the diaphragm was recognized.

Keywords: congenital diaphragmatic hernia; congenital pulmonary airway malformation; extralobar pulmonary sequestration.

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