Department of General Thoracic Surgery, Okayama University Hospital, Okayama, Japan.
Interact Cardiovasc Thorac Surg. 2021 May 10;32(5):831-833. doi: 10.1093/icvts/ivaa331.
Lung gangrene is a potentially fatal disease, and primary or staged surgery, depending on the patient's condition, is reported to be useful. We describe successful management, by staged surgery, of a rare case of empyema and lung gangrene complicating lung radiofrequency ablation. The patient, who was a diabetic with colorectal pulmonary metastases, underwent embolization of a pulmonary artery pseudoaneurysm in the right basal segment that developed after lung radiofrequency ablation. He subsequently developed lung gangrene caused by lung ischaemia, and empyema, necessitating pleural decortication followed by open-window thoracostomy. Subsequently, right basal segmentectomy was performed, with thoracostoma closure. Staged surgery might be beneficial for high-risk patients with empyema and lung gangrene caused by lung ischaemia.
肺坏疽是一种潜在致命的疾病，据报道，根据患者的情况，进行一期或分期手术是有用的。我们描述了一例罕见的胸腔积脓和肺坏疽合并肺射频消融术后的成功分期手术治疗。患者为糖尿病合并结直肠肺转移，在肺射频消融术后发生右下基底段肺动脉假性动脉瘤，行血管栓塞治疗。随后发生肺缺血引起的肺坏疽和脓胸，需要行胸膜剥脱术，然后行开窗口式胸廓切开术。随后进行右基底段切除术，并关闭胸管。分期手术可能对因肺缺血引起的脓胸和肺坏疽的高危患者有益。
