Ichimura Hideo, Ozawa Yuichiro, Nishina Hidetaka, Shiotani Seiji
Department of General Thoracic Surgery, Tsukuba Medical Center Hospital, Tsukuba, Ibaraki, Japan.
Ann Thorac Cardiovasc Surg. 2014;20 Suppl:613-6. doi: 10.5761/atcs.cr.13-00079. Epub 2013 Jun 18.
Left upper lobectomy may be followed by complications such as thrombus formation in a stump of the left superior pulmonary vein (LSPV), which may cause systemic embolization. We have encountered four such cases, which account for 3.4% of all left upper lobectomies performed at our institution. Right renal infarction was observed in one of these four cases; the remaining cases were asymptomatic, with the thrombus incidentally detected by enhanced computed tomography (CT). The postoperative duration for the detection of the thrombus varied from 4 days to 24 months. Even in a case in which the superior pulmonary vein (PV) was divided by posterolateral thoracotomy, CT showed that the stump was long enough intrapericardially for thrombus formation. Anticoagulant therapy was administered in all the cases, resulting in dissipation of the thrombus. Therefore, when a thrombus is detected in a pulmonary stump, an anticoagulant should be administered.
左上叶切除术后可能会出现并发症，如左上肺静脉（LSPV）残端形成血栓，这可能导致全身栓塞。我们遇到了4例这样的病例，占我们机构所有左上叶切除术的3.4%。这4例中有1例观察到右肾梗死；其余病例无症状，血栓通过增强计算机断层扫描（CT）偶然发现。血栓检测的术后时间从4天到24个月不等。即使在通过后外侧开胸术切断肺上静脉（PV）的病例中，CT显示心包内残端足够长，足以形成血栓。所有病例均给予抗凝治疗，血栓消散。因此，当在肺残端检测到血栓时，应给予抗凝剂。
