Onuki Takamasa, Kanzaki Masato, Maeda Hideyuki, Sakamoto Kei, Isaka Tamami, Oyama Kunihiro, Murasugi Masahide
Division of Pulmonary Medicine, Shonantobu General Hospital, Chigasaki, Kanagawa, Japan.
Department of Surgery 1, Tokyo Women's Medical University, Tokyo, Japan.
Ann Thorac Cardiovasc Surg. 2019 Feb 20;25(1):56-59. doi: 10.5761/atcs.cr.17-00146. Epub 2018 Feb 20.
Because left upper division resection is similar to right upper lobectomy, this procedure is frequently employed. Few studies have used the anatomic courses of veins evaluated on preoperative computed tomography (CT) imaging to determine what types of patients are at the highest risk for hemorrhagic pulmonary infarction.
We describe our experience with a patient in whom hemorrhagic pulmonary infarction occurred at 6 days after transecting two superior branches (V and V) of the three branches of the left superior pulmonary vein. We preoperatively confirmed that small-caliber lingular veins were perfused by V. However, the patient had a poor pulmonary function, and the tumor was located distal to V. Left upper division resection was therefore performed.
The division of V could be the cause of hemorrhagic infarction in the lingular segment after upper division segmentectomy.
由于左上叶切除类似于右上叶切除，该手术常被采用。很少有研究利用术前计算机断层扫描（CT）成像评估的静脉解剖走行来确定哪些类型的患者发生出血性肺梗死的风险最高。
我们描述了一名患者的情况，该患者在切断左上肺静脉三个分支中的两个上支（V和V）后6天发生了出血性肺梗死。我们术前确认小口径的舌叶静脉由V供血。然而，该患者肺功能较差，肿瘤位于V的远端。因此进行了左上叶切除。
V的离断可能是上叶切除术后舌叶段出血性梗死的原因。
