Sakaguchi K, Horio H, Yamamoto M
Department of Thoracic Surgery, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan.
Kyobu Geka. 2007 Sep;60(10):907-9.
A 58-year-old man underwent video-assisted thoracoscopic right upper lobectomy. He was discharged without event on postoperative day 8. On postoperative day 12, he visited emergently in a pre-shock state. Chest radiography showed massive right pleural effusion and intrathoracic bleeding was suspected. Thoracotomy was immediately performed and the bleeding point was identified as an internal thoracic artery. Hemostasis was performed but no cause of arterial injury was apparent. In another case, we had seen incidental snag the pleura on the internal thoracic artery by a staple from interlobar plasty of the lung. We therefore suspected that the cause in this case was injury of the internal thoracic artery by staple during video-assisted thoracoscopic interlobar plasty of the lung.
一名58岁男性接受了电视辅助胸腔镜右上叶切除术。他在术后第8天顺利出院。术后第12天，他因处于休克前期紧急就诊。胸部X线检查显示大量右侧胸腔积液，怀疑有胸腔内出血。立即进行了开胸手术，出血点被确定为胸廓内动脉。进行了止血，但动脉损伤的原因不明显。在另一例病例中，我们曾看到在肺叶间成形术用吻合钉偶然钩住胸廓内动脉的胸膜。因此，我们怀疑本例的原因是在电视辅助胸腔镜肺叶间成形术期间吻合钉对胸廓内动脉造成了损伤。
