Surgical management of pulmonary isolation disease OBJECTIVE: To investigate the diagnosis, classification and surgical treatment of pulmonary isolation disease. METHODS: The diagnosis and treatment of 9 clinical cases were retrospectively analyzed and the relevant literature was reviewed. RESULTS: From January 2006 to January 2013, 9 cases of pulmonary isolation disease were admitted and confirmed by surgery and pathology, 5 males and 4 females, age of onset 19-46 years, 8 intralobular cases and 1 extralobular case, lesions located in the left lung in 7 cases and in the right lung in 2 cases, preoperative diagnosis rate of 55.56%, all cured by surgery. Conclusion: Pulmonary segregation is a rare congenital malformation of the lung, with a lack of specificity in clinical manifestations and a low preoperative diagnosis rate. Pulmonary segregation; Classification; Diagnosis; Surgical treatment Pulmonary segregation (PS) refers to the isolation of an abnormal segment or lobe of the lung from normal lung tissue, forming a relatively isolated lung. It accounts for 0.15-6.4% of congenital malformations of the lung [1]. The clinical diagnosis, classification and surgical treatment of the nine cases of surgically and pathologically confirmed pulmonary segregation admitted from January 2006 to January 2013 were reviewed, combined with a review of the literature in recent years in domestic medical journals. 1. Data and methods 1.1 Nine cases in this group, five males and four females; age of onset 19-46 years old, mean age 28.16 years old. There were 2 cases of recurrent and intermittent cough, sputum and fever; 1 case of recurrent sputum and blood; 4 cases of recurrent and intermittent cough, sputum and fever with hemoptysis or sputum and blood; 1 case of chest pain; 1 case of asymptomatic physical examination. The duration of the disease ranged from 3 months to 8 years. There were 6 cases of left lower lung intralobar and posterior basal segment intralobar type, 1 case of left lower lung extralobar type and 2 cases of right lower lung intralobar and posterior basal segment intralobar type. 1.2 Imaging data X-rays in one case suggested a uniform density, well-defined margins, and lobulated mass in the left supra-diaphragmatic chest. 9 cases underwent 16-row spiral CT scan of the chest before surgery, and the imaging features of the lesion were solid in 4 cases, cystic in 3 cases, and cystic solid in 2 cases; all were confirmed by enhanced CT scan, and reconstruction showed isolated pulmonary anomalous blood supply artery in 4 cases. The diagnosis was confirmed in one case by MRI, which showed the isolated pulmonary blood supply artery and the draining vein by revascularization. No aortogram was performed in all cases. The preoperative examination of 1.39 cases confirmed the diagnosis in 5 cases, with a confirmation rate of 55.56%; the preoperative misdiagnosis was 1 case of pulmonary cyst co-infection, 1 case of bronchiectasis, 1 case of tuberculosis ball, and 1 case of lung cancer, with a misdiagnosis rate of 44.44%. 1.4 Surgical treatment All 9 cases received surgical treatment, including 7 cases of conventional open-heart surgery and 2 cases of thoracoscopic surgery (VATS). Eight cases underwent lobectomy in the intralobar type and one case underwent thoracoscopic simple isolated pneumonectomy in the extralobar type. 2. Results All 9 cases were diagnosed with pulmonary isolation after surgery. All of them were cured and there was no death; there were no surgical complications such as infection, bleeding, pulmonary atelectasis and respiratory failure during the perioperative period. 3, Discussion Pulmonary isolation is a rare congenital malformation of the lung, which is a non-functional embryonic-like lung separated from normal lung tissue formed during embryonic development. In conclusion, pulmonary segregation is a rare congenital malformation of the lung, and the prognosis for surgical treatment is good when the diagnosis, classification, timing of surgery and resection methods of pulmonary segregation are reasonably mastered and the corresponding management plan is prepared.