Tanaka Ryota, Nakazato Yoshimasa, Fukura Haruhiko, Horikoshi Hiroyuki, Sawada Toshio, Goya Tomoyuki
Department of Thoracic Surgery, Gunma Prefectural Cancer Center, 617-1 Takabayashi-nishi-machi, Ohta, Gunma, 373-8550, Japan.
Surg Today. 2008;38(2):147-9. doi: 10.1007/s00595-007-3580-y. Epub 2008 Feb 1.
A partial anomalous pulmonary venous connection (PAPVC) is an uncommon congenital anomaly which is frequently associated with congenital heart disease such as an atrial-level shunt. This report documents the case of an 81-year-old man with PAPVC which was incidentally discovered during a right upper lobectomy for lung cancer. Surgery was performed through a minithoracotomy of an auscultatory triangle using a video-assisted procedure (video-assisted thoracic surgery: VATS). Although the ramus lobi medii was connected normally, the right superior lobe vein was found to drain into the superior vena cava. The surgery was successful, and the patient had an uneventful postoperative course. Asymptomatic PAPVC without an atrial septal defect (ASD) is extremely rare. If the PAPVC is located in a different lobe, a pulmonary resection for lung cancer would precipitate an adverse outcome without a correction of the PAPVC. Surgeons should therefore be cautious regarding the potential existence of a PAPVC when a patient undergoes surgical procedures, especially VATS, for lung cancer.
部分性肺静脉异位连接(PAPVC)是一种不常见的先天性异常,常与先天性心脏病如心房水平分流相关。本报告记录了一例81岁男性患者,其PAPVC在因肺癌行右上叶切除术中偶然被发现。手术通过听诊三角的小切口开胸,采用电视辅助手术(电视辅助胸腔镜手术:VATS)进行。尽管中叶支连接正常,但发现右上叶静脉汇入上腔静脉。手术成功,患者术后恢复顺利。无症状且无房间隔缺损(ASD)的PAPVC极为罕见。如果PAPVC位于不同肺叶,在未纠正PAPVC的情况下,因肺癌进行肺切除会导致不良后果。因此,当患者接受肺癌手术,尤其是VATS手术时,外科医生应谨慎考虑PAPVC存在的可能性。