Oda Kazuyuki, Kanzaki Ryu, Fujiwara Ayako, Maeda Jun, Okami Jiro, Hiraishi Taizo, Takami Hiroshi, Higashiyama Masahiko, Kodama Ken
Department of Thoracic Surgery, Sakai Municipal Hospital, Sakai, Japan.
Kyobu Geka. 2011 Mar;64(3):202-5.
A 69-year-old man with right aortic arch was diagnosed as having left lung cancer (cT2aN1M0, cStage IIA) and an aneurysm of an aberrant left subclavian artery. The aneurysm measured 36 mm in diameter and was located 1 cm peripheral from the origin in the area known as "Kommerell's diverticulu Left carotid artery-to-left subclavian artery bypass graft was placed through a left supraclavicular incision prior to thoracotomy. This bypass graft effectively prevented neurological and ischemic complications of the brain and left upper extremity while we safely and successfully performed resection of the aneurysm along with radical surgery for left lung cancer through left thoracotomy. There have been only 10 case reports, including the present case, that have described surgical resection of lung cancer in a patient with right aortic arch. In addition, this is the 1st report to describe simultaneous surgery for both left lung cancer and an aneurysm of an aberrant left subclavian artery in a patient with right aortic arch.
一名69岁男性，有右位主动脉弓，被诊断为左肺癌（cT2aN1M0，cIIA期）以及异常左锁骨下动脉动脉瘤。该动脉瘤直径36毫米，位于距起源处外周1厘米的所谓“Kommerell憩室”区域。在开胸手术前，经左锁骨上切口进行了左颈动脉至左锁骨下动脉搭桥移植术。该搭桥移植术有效预防了脑部和左上肢的神经及缺血性并发症，同时我们通过左胸开胸术安全且成功地切除了动脉瘤以及对左肺癌进行了根治性手术。包括本病例在内，仅有10例病例报告描述了右位主动脉弓患者的肺癌手术切除情况。此外，这是首例描述右位主动脉弓患者同时进行左肺癌和异常左锁骨下动脉动脉瘤手术的报告。
