Department of Thoracic and Cardiovascular Surgery, Graduate School of Medicine, Hirosaki University, 5 Zaifu-cho, Hirosaki, 036-8562, Aomori, Japan.
Gen Thorac Cardiovasc Surg. 2020 Sep;68(9):1047-1050. doi: 10.1007/s11748-019-01200-9. Epub 2019 Sep 9.
Left upper lobectomy (LUL) has been considered to have a higher risk of thrombus formation in the pulmonary vein stump (PVS) than other lobectomies. A case of thrombus formation in the PVS and right renal infarction detected by contrast-enhanced computed tomography (CECT) 12 days after LUL is presented. The thrombus in the PVS was considered to be related to the renal infarction because of the lack of other potential explanations. After intravenous heparin treatment for 1 week and continuous oral anticoagulation, the thrombus in the PVS became smaller 3 months after the operation, and it basically disappeared after 1 year. Scar formation was detected in the area of renal infarction 3 months after the operation, and no specific change was detected from then on. One should consider performing postoperative chest and abdominal CECT routinely within 1 week after LUL, and, if thrombosis is found, antithrombotic therapy might then be given.
左肺上叶切除术(LUL)被认为比其他肺叶切除术更容易在肺静脉残端(PVS)形成血栓。本文报告了一例 LUL 术后 12 天通过增强计算机断层扫描(CECT)发现 PVS 血栓形成和右肾梗死的病例。由于缺乏其他潜在的解释,因此认为 PVS 中的血栓与肾梗死有关。静脉内肝素治疗 1 周和持续口服抗凝治疗后,术后 3 个月 PVS 中的血栓变小,1 年后基本消失。术后 3 个月在肾梗死区域检测到瘢痕形成,此后未检测到特定变化。应考虑在 LUL 后 1 周内常规进行术后胸部和腹部 CECT,如果发现血栓,则可能给予抗血栓治疗。