Nagano Taichi, Haratake Naoki, Matsudo Kyoto, Hashinokuchi Asato, Watanabe Kenji, Takamori Shinkichi, Kohno Mikihiro, Miura Naoko, Takenaka Tomoyoshi, Yoshizumi Tomoharu
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Transl Cancer Res. 2023 Feb 28;12(2):421-426. doi: 10.21037/tcr-22-2104. Epub 2023 Feb 6.
Currently, segmentectomy is the procedure of choice in approximately 10% of lung cancer surgeries in Japan. However, complications are often observed in that procedure. In particular, residual pulmonary congestion after segmentectomy often leads to surgical intervention.
We report a case of improved congestion in the residual lung after left upper trisegmentectomy (LUTS) with conservative treatment under careful observation. A 65-year-old man was diagnosed with bilateral lung cancer and initially underwent LUTS. On the next day after surgery, blood sputum was observed. Computed tomography (CT) showed consolidation in the lingual region of the left lung and stenosis of V4+5 in the left lung. The cause of the congestion was thought to be an isolated segment with part of the remaining S3 and a thin V4+5 with poor flow. Because pulmonary torsion or necrosis of the residual lung was not observed, conservative treatment with antibiotics under careful follow-up by CT was chosen. The pulmonary congestion and inflammatory reaction gradually improved, and the patient was discharged home on the 26th day after surgery.
We experienced a case of residual pulmonary congestion after LUTS that resolved with conservative treatment. Careful follow-up of the patient's general condition and imaging studies are considered to be important.
目前，在日本约10%的肺癌手术中，肺段切除术是首选术式。然而，该手术常出现并发症。特别是肺段切除术后残留肺淤血常导致手术干预。
我们报告1例左上三叶肺段切除术（LUTS）后经仔细观察下保守治疗，残留肺淤血得到改善的病例。一名65岁男性被诊断为双侧肺癌，最初接受了LUTS。术后第二天观察到血痰。计算机断层扫描（CT）显示左肺舌叶区域实变以及左肺V4+5狭窄。淤血原因被认为是剩余S3的一部分孤立肺段以及血流不佳的纤细V4+5。由于未观察到残留肺的肺扭转或坏死，选择在CT仔细随访下用抗生素进行保守治疗。肺淤血和炎症反应逐渐改善，患者在术后第26天出院。
我们遇到1例LUTS术后残留肺淤血经保守治疗得以解决的病例。对患者一般状况和影像学检查进行仔细随访被认为很重要。
