Masuda Yoshiko, Marutsuka Takashi, Saishoji Tetsushi
Department of Thoracic Surgery, Kumamoto Chuo Hospital, Kumamoto, Japan.
Kyobu Geka. 2013 Jun;66(6):481-4.
Situs inversus, which occurs in 1-2 of every 10,000 births, is a congenital malformation in which the thoracic and abdominal viscera are arranged in partial on complete mirror image of the normal anatomy. In the case of situs inversus, special attention must be taken in performing surgery. We present a surgical case of primary lung cancer in an 81-year-old patient with situs inversus totalis. During surgery, we used the Univent bronchial tube for one-lung ventilation. The appearance of the right lung and the arrangement of the pulmonary vessels and the bronchi corresponded to those normally found on the right side was noted at left thoracotomy. Left middle lobectomy and partial resection of left upper lung were successfully performed. In lung resection for situs inversus, it is important to be aware the mirrorimage anatomy. The three dimensional computed tomography (3D-CT) images were useful for preoperative evaluation of vessel variation.
内脏反位发生率为每10000例出生中有1 - 2例，是一种先天性畸形，其中胸腹部脏器以正常解剖结构的部分或完全镜像形式排列。对于内脏反位患者，手术时必须格外小心。我们展示了一例81岁完全性内脏反位患者的原发性肺癌手术病例。手术过程中，我们使用单腔支气管导管进行单肺通气。左胸开胸时发现右肺外观以及肺血管和支气管的排列与正常右侧的情况一致。成功实施了左肺中叶切除术和左上肺部分切除术。在为内脏反位患者进行肺切除时，了解镜像解剖结构很重要。三维计算机断层扫描（3D - CT）图像有助于术前评估血管变异情况。
