Wong P S, Goldstraw P
Royal Brompton National Heart and Lung Hospital, London, England.
Ann Thorac Surg. 1992 Aug;54(2):286-8. doi: 10.1016/0003-4975(92)91386-n.
Pulmonary torsion is a rare but life-threatening complication of thoracic operations and trauma. A questionnaire was sent to 140 thoracic surgeons in the United Kingdom to examine its incidence, particularly torsion of the middle lobe after right upper lobectomy. The answers from 117 thoracic surgeons (84%) were collected and analyzed. Thirty-five responders (30%) had seen one or more cases of pulmonary torsion. The majority of cases occurred after pulmonary resection, and most of these instances involved middle lobe torsion after right upper lobectomy. In total, 39 cases were reported; 1 (3%) occurred spontaneously in an azygos lobe, 2 (5%) were seen after trauma, 28 (72%) were seen after pulmonary resections and 8 (21%), after other procedures. In this group of responders, 27 (77%) routinely fix the middle lobe to the remaining lobe after right upper or lower lobectomy, upper lobe fixation being required only if the transverse fissure is well developed. Of the 82 responders who had never seen instances of pulmonary torsion, only 47 (57%) routinely do this fixation.
肺扭转是一种罕见但危及生命的胸科手术及创伤并发症。我们向英国的140位胸外科医生发放了一份调查问卷，以调查其发生率，特别是右上肺叶切除术后中叶扭转的发生率。我们收集并分析了117位胸外科医生（84%）的回复。35位回复者（30%）见过1例或更多例肺扭转病例。大多数病例发生在肺切除术后，其中大部分是右上肺叶切除术后的中叶扭转。总共报告了39例病例；1例（3%）发生在奇叶自发性扭转，2例（5%）发生于创伤后，28例（72%）发生于肺切除术后，8例（21%）发生于其他手术之后。在这组回复者中，27位（77%）在右上叶或下叶切除术后常规将中叶固定于剩余肺叶，仅当横裂发育良好时才需要固定上叶。在82位从未见过肺扭转病例的回复者中，只有47位（57%）常规进行这种固定。
