Bilateral Video-Assisted Thoracoscopic Resection for a Patient With Horseshoe Intralobar Pulmonary Sequestration: A Novel Minimally Invasive Approach.

We encountered a rare case of bilateral intralobar pulmonary sequestration presenting as horseshoe lung. A 44-year-old asymptomatic woman was referred to our hospital because of increased serum cancer antigen 125 and carbohydrate antigen 19-9, accompanied by an abnormal chest shadow. Preoperative imaging indicated a horseshoe-shaped bilateral intralobar pulmonary sequestration diagnosis. The surgery was initiated on the left side in a semiprone right lateral decubitus position. The aberrant vessels arising from the descending aorta were divided, and after indocyanine green administration, the boundary between the normal and sequestrated lungs was determined and stapled. The left and right pleural cavities were connected, and the left sequestrated lung was pushed into the right thoracic cavity. The right sequestrated lung was similarly resected via the right-sided approach, and both were resected en bloc. Both tumor markers were normalized 3 months postoperatively. We safely performed thoracoscopic surgery by formulating an appropriate surgical plan.