Clinical management of Extralobar pulmonary sequestration in
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Extralobar pulmonary sequestration (ELS) is also treated differently. The aim of this study is to show the characteristics of ELS in children in order to have better clinical management in the future. A retrospective analysis was conducted for ELS patients treatment. In total, 85 patients were included, containing 70 upper-diaphragmatic, 7 intra-diaphragmatic, and 8 infra-diaphragmatic ELS.

--8 patients pathology results showing inflammation without symptoms preoperatively and 2 patients had chest pain for torsion.

--All the upper-diaphragmatic and intra-diaphragmatic ELS patients accepted thoracoscopic surgery resection.

--The intraoperative operation time and blood loss volume of intra-diaphragmatic ELS were significantly more than that of the upper-diaphragmatic (40.14±9.92 vs. 23.07±6.79 min; 9.29±3.45 vs. 3.18±4.94 ml).

--No chest tubes were inserted in both subgroups. No complications were found in the postoperative follow-up of operative ELS patients for at least 3 months.

--A total of 8 infra-diaphragmatic ELS patients except for one (7/8) had conservative therapy and follow-up was done by the outpatient clinic or phone call eventually.

--There were no symptoms & increase of size observed in infra-diaphragmatic ELS.

In conclusion, in this analysis, the ELS poses a risk of infection and torsion. Thoracoscopic surgery, with its limited invasion and low perioperative complications, could be the best option for treating upper diaphragmatic ELS. It can be done as a day procedure with a safe and fast recovery. To get a better management approach, the intradiaphragmatic and infradiaphragmatic ELS need a greater sample size and data from different centers.