Yamada Shunsuke, Kohno Tadasu, Abe Yoshiaki
Department of Thoracic Surgery, Toranomon Hospital, Tokyo, Japan.
Jpn J Thorac Cardiovasc Surg. 2003 Nov;51(11):626-9. doi: 10.1007/BF02736706.
A 38-year-old man, who had undergone surgery for gastric cancer one year previously, was found to have two pulmonary nodules (PNs: 10 mm in diameter) on chest radiography. Computed tomography (CT) revealed one of these nodules to be located near the B6b in the right lung hilus, while the other was located in the superficial region of the left lower lobe. Video-assisted thoracic surgery (VATS) was performed, for both diagnostic and therapeutic purposes. In this procedure, after preoperative CT-guided marking, simultaneous subsegmental resection of the right S6b and VATS wedge resection of the left lower lobe were performed successfully with adequate surgical margin. Histological diagnosis was compatible with metastatic pulmonary tumor from a gastric carcinoma primary. This case demonstrates that preoperative CT-guided localization can facilitate safe VATS subsegmental resection of a small deep pulmonary nodule.
一名38岁男性，一年前因胃癌接受了手术，胸部X线检查发现有两个肺结节（直径10毫米）。计算机断层扫描（CT）显示其中一个结节位于右肺门B6b附近，另一个位于左下叶浅表区域。为了诊断和治疗目的，进行了电视辅助胸腔镜手术（VATS）。在该手术中，术前经CT引导标记后，成功地对右S6b进行了亚段切除，并对左下叶进行了VATS楔形切除，手术切缘足够。组织学诊断与原发性胃癌转移至肺部肿瘤相符。该病例表明，术前CT引导定位有助于安全地对小的深部肺结节进行VATS亚段切除。
