Department of General Thoracic Surgery, Kagoshima University Graduate School of Dental and Medical Science, Kagoshima, Japan.
Department of General Thoracic Surgery, Kagoshima University Graduate School of Dental and Medical Science, Kagoshima, Japan.
Ann Thorac Surg. 2020 Oct;110(4):e303-e305. doi: 10.1016/j.athoracsur.2019.09.091. Epub 2019 Nov 22.
Scoliosis can cause various respiratory complications, even in the natural course, because of rearrangement of the intrathoracic anatomy owing to chest wall deformity. We experienced a patient with scoliosis who developed acute respiratory failure owing to bronchial obstruction induced by bronchial compression by the dorsal thoracic vertebra after right upper lobectomy for cancer. The symptom resolved after mobilization of the ipsilateral lower lobe, which was achieved by releasing the inferior pulmonary vein by U-shaped pericardial dissection with division of the pulmonary ligament. When planning lobectomy for patients with severe scoliosis, the anatomic changes caused by pulmonary resection must be considered.
脊柱侧凸可导致各种呼吸系统并发症，即使在自然病程中，也会由于胸廓畸形导致胸腔内解剖结构的重新排列。我们曾遇到 1 例脊柱侧凸患者，因右上肺叶癌行右上肺叶切除术后，背侧胸椎压迫支气管引起支气管阻塞，导致急性呼吸衰竭。通过 U 形心包切开术切断肺韧带，游离下肺静脉，使同侧下肺叶得以活动，症状缓解。在为严重脊柱侧凸患者行肺叶切除术时，必须考虑到肺切除引起的解剖变化。
