胸外科中的腔静脉异常
Vena cava anomalies in thoracic surgery.
作者信息
Pagini Andreina, Bassi Massimiliano, Diso Daniele, Anzidei Michele, Mantovani Sara, Poggi Camilla, Venuta Federico, Anile Marco
机构信息
Division of Thoracic Surgery, Department of General Surgery and Organ Transplant "PARIDE STEFANINI", Policlinico Umberto I, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.
Department of Radiology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
出版信息
J Cardiothorac Surg. 2018 Feb 1;13(1):19. doi: 10.1186/s13019-018-0704-y.
BACKGROUND
Vena cava anomalies are a rare group of anatomical variations due to an incorrect development of the superior or inferior vena cava during fetal life. They generally show no clinical relevance and the diagnosis is done due to the association with congenital heart diseases in most of cases. However, preoperative identification of these anomalies is mandatory for surgeons to proper surgical planning. If not recognized, lethal complications may occur, as already reported in literature.
CASE PRESENTATION
We report a case series of three different unidentified vena cava anomalies in patients undergoing lung resection. These unrecognized anomalies led to minor complications in two cases and required an accurate intraoperative evaluation in another. A careful retrospective evaluation of preoperative radiological images showed the anomalies.
CONCLUSIONS
A careful evaluation of the vena cava anatomy at pre-operative imaging is mandatory for thoracic surgeons to properly plan the surgery and avoid complications.
背景
腔静脉异常是一组罕见的解剖变异，是由于胎儿期上腔静脉或下腔静脉发育异常所致。它们通常无临床意义，多数情况下是因与先天性心脏病相关而得以诊断。然而，术前识别这些异常对于外科医生进行恰当的手术规划至关重要。如文献中已有报道，若未被识别，可能会发生致命并发症。
病例报告
我们报告了一组在接受肺切除术患者中出现的三例不同的未被识别的腔静脉异常病例。这些未被识别的异常在两例中导致了轻微并发症，在另一例中则需要进行准确的术中评估。对术前放射影像进行仔细的回顾性评估显示了这些异常。
结论
胸外科医生在术前影像检查时仔细评估腔静脉解剖结构对于恰当规划手术和避免并发症是必不可少的。
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