Akabane Miho, Kohno Tadasu, Fujimori Sakashi, Kimura Naoko, Suzuki Souichirou, Kawashima Mitsuaki, Kikunaga Shinichirou
Department of Thoracic Surgery, Respiratory Centre, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan.
Department of Thoracic Surgery, Respiratory Centre, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan.
Int J Surg Case Rep. 2019;54:66-69. doi: 10.1016/j.ijscr.2018.11.054. Epub 2018 Nov 24.
Simultaneous resection of bilateral lung cancers is technically challenging but may be preferable to a staged procedure in patients with a partial anomalous pulmonary venous connection (PAPVC) in an affected lobe. We performed single-stage resection of bilateral lung cancers in a patient with a PAPVC.
A 73-year-old man was diagnosed as having bilateral lung cancers (right, cT3N1M0, stage IIIA and left, cT2aN0M0, stage IB). Left upper trisegmentectomy was performed, followed by right upper lobectomy with deep wedge bronchoplasty. A PAPVC was found incidentally in the affected right upper lobe and successfully divided. The postoperative course was uneventful and he commenced chemoradiotherapy.
Resection of the PAPVC, which was located in the same lobe as the lung cancer, would have mitigated load increase in the right heart and may have alleviated the adverse effects of bilateral lung resection. Moreover, the single-stage procedure likely shortened the overall duration of treatment.
Single-stage bilateral thoracoscopic resection may have advantages over staged procedures in some patients with PAPVCs.
同时切除双侧肺癌在技术上具有挑战性，但对于患侧肺叶存在部分性肺静脉异位连接（PAPVC）的患者而言，可能比分期手术更为可取。我们对一名患有PAPVC的患者进行了双侧肺癌的一期切除手术。
一名73岁男性被诊断为双侧肺癌（右侧，cT3N1M0，ⅢA期；左侧，cT2aN0M0，ⅠB期）。先进行了左肺上叶三段切除术，随后进行了右上叶切除术及深部楔形支气管成形术。在患侧右上叶偶然发现了一个PAPVC，并成功将其分离。术后过程顺利，患者开始接受放化疗。
切除位于与肺癌同一肺叶的PAPVC，可能减轻了右心的负荷增加，并可能缓解了双侧肺切除的不良影响。此外，一期手术可能缩短了总的治疗时间。
对于一些患有PAPVC的患者，一期双侧胸腔镜切除术可能比分期手术更具优势。
