Kawamura Masaki, Kikuchi Naohiko, Abe Jiro, Katahira Masato, Miyabe Shingo
Department of Thoracic Surgery, Miyagi Cancer Center, Natori, Japan.
Kyobu Geka. 2021 Mar;74(3):209-212.
A 64-year-old woman diagnosed as primary lung cancer was admitted for surgery. Right lower lobectomy and ND2a-1 nodal dissection was performed under video-assisted thoracic surgery( VATS). The membranous portion of intermediate bronchus was injured about length of 5 mm while dissecting subcarinal lymph nodes. The fistula was closed by knotted suture using 4-0 polydioxanone (PDS) and covered with pericardial fat pad. Although the postoperative course was uneventful and discharged at postoperative day (POD) nine, bloody sputum appeared and right pneumothorax developed at POD 11. Bronchoscopy revealed a slit-like bronchopleural fistula at intermediate bronchus. By continuous thoracic drainage, the fistula successfully closed at POD 13.
一名被诊断为原发性肺癌的64岁女性因手术入院。在电视辅助胸腔镜手术(VATS)下进行了右下叶切除术和ND2a-1淋巴结清扫术。在解剖隆突下淋巴结时,中间支气管的膜部受伤约5毫米。用4-0聚二氧六环酮(PDS)打结缝合封闭瘘口,并用心包脂肪垫覆盖。尽管术后过程顺利,术后第9天出院,但术后第11天出现血性痰并发生右侧气胸。支气管镜检查显示中间支气管有一裂隙样支气管胸膜瘘。通过持续胸腔引流,瘘口在术后第13天成功闭合。