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双侧肺同期切除术后张力性气胸

[Tension pneumothorax after simultaneous bilateral lung resection].

作者信息

Kase M, Kurata H, Yamagata T, Okamoto M, Tsushima Y

机构信息

Department of Thoracic Surgery, Yokohama Municipal Citizens Hospital, Yokohama, Japan.

出版信息

Kyobu Geka. 2001 Dec;54(13):1142-4.

Abstract

A 72-year-old man was admitted to our hospital because of an abnormal shadow on chest X-ray film. Chest CT showed a mass 6 cm in diameter in left S1 + 2, and a small round mass in right S2. Left side mass was diagnosed squamous cell carcinoma by transbronchial biopsy, but right side mass was unidentified. We performed partial resection for a right S2 mass with VATS, and then left upper lobe lobectomy and mediastinal lymph node dissection simultaneously. Pathological examination revealed the right mass was hamartoma. He discharged on 16 postoperative days uneventfully. But 3 days after he was sent to our hospital on emergency because dyspnea and unconscious. Chest X-ray revealed right side tension pneumothorax, then he was recovered by chest tube insertion. At re-thoracotomy we confirmed air leakage was occurred from a ruptured bulla that was leaved at first operation.

摘要

一名72岁男性因胸部X线片出现异常阴影而入住我院。胸部CT显示左肺上叶尖后段(S1 + 2)有一个直径6厘米的肿块,右肺上叶前段(S2)有一个小圆形肿块。经支气管活检诊断左侧肿块为鳞状细胞癌,但右侧肿块性质不明。我们通过电视辅助胸腔镜手术(VATS)对右肺S2肿块进行了部分切除,然后同时进行了左肺上叶切除术和纵隔淋巴结清扫术。病理检查显示右侧肿块为错构瘤。术后第16天他顺利出院。但出院3天后,他因呼吸困难和昏迷被紧急送往我院。胸部X线显示右侧张力性气胸,随后通过插入胸管使其恢复。再次开胸时,我们证实漏气是由于首次手术时遗留的一个破裂肺大疱所致。

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