Iwata Hitomi, Fukuhara Naoki, Iizuka Hirotaka, Kanai Masanori, Oshima Masayuki
Masui. 2014 Oct;63(10):1103-5.
We experienced a case of pneumothorax in a patient with complete situs inversus. A 30-year-old man was scheduled for partial resection of the left lung under video assisted thoracic surgery. He had asymptomatic complete situs inversus. We advanced a bronchial blocker easily into the left (anatomically right) main bronchus under fiberoptic guidance. One lung ventilation during the operation was performed successfully. The chest X-ray after the surgery showed an atelectasis of the left upper lobe. After endotracheal suction, we extubated him and noticed improvement of atelectasis. There are several ways of one lung ventilation in patients with situs inversus. To use a bronchial blocker is one of the effective choices. However, in some cases, it is necessary to consider using a double-lumen tube depending on the case considering the anatomical structure and the characteristics of the procedure.
我们遇到了一例全内脏转位患者发生气胸的病例。一名30岁男性计划在电视辅助胸腔镜手术下行左肺部分切除术。他有无症状的全内脏转位。在纤维支气管镜引导下，我们轻松地将支气管封堵器插入左（解剖学上的右）主支气管。手术过程中成功进行了单肺通气。术后胸部X线显示左上叶肺不张。气管内吸引后，我们为他拔除气管插管，发现肺不张有所改善。对于内脏转位患者，有几种单肺通气的方法。使用支气管封堵器是有效的选择之一。然而，在某些情况下，根据病例的解剖结构和手术特点，有必要考虑使用双腔管。
