Otsuka Hajime, Hata Yoshinobu, Takagi Keigo, Sato Fumitomo
Department of Chest Surgery, Toho University Medical Center Omori Hospital, Tokyo, Japan.
Interact Cardiovasc Thorac Surg. 2013 May;16(5):718-20. doi: 10.1093/icvts/ivt047. Epub 2013 Feb 13.
A 22-year old man presented with a massive haemothorax 25 days after bullectomy for a spontaneous pneumothorax. Thoracoscopic surgery revealed ongoing bleeding from the chest wall caused by a sharp edge of the Endoloop Ligature (Ethicon Endo-Surgery) used to resect the remaining small part of the lung at the earlier staple bullectomy. The point where bleeding was occurring was clipped and covered using a collagen patch coated with human fibrinogen and thrombin. The protruding sharp edge of the Endoloop was excised together with the surrounding lung tissue, using a stapler. Although prevention of this type of complication is difficult, awareness of the potential problem may help in managing such extremely rare events.
一名22岁男性在因自发性气胸行肺大疱切除术后25天出现大量血胸。胸腔镜手术显示，出血来自胸壁，是由用于在早期吻合器肺大疱切除术中切除剩余小部分肺组织的Endoloop结扎线（爱惜康内镜外科公司生产）的锐利边缘所致。出血点用涂有人纤维蛋白原和凝血酶的胶原贴片进行夹闭和覆盖。使用吻合器将Endoloop突出的锐利边缘与周围肺组织一并切除。尽管预防此类并发症很困难，但意识到潜在问题可能有助于处理这种极其罕见的情况。
