Department of Thoracic Surgery, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610044, Sichuan, P.R. China.
J Cardiothorac Surg. 2023 Oct 10;18(1):279. doi: 10.1186/s13019-023-02374-3.
Thoracoscopic lobectomy is a common surgical procedure for the treatment of lung cancer. With the continuous development of surgical techniques and medical devices, complications after thoracoscopic lobectomy are less and less, and cardiac tamponade is even rarer. This case is a 62-year-old woman who underwent thoracoscopic left upper lobectomy for a left upper lobe nodule. The patient developed acute cardiac tamponade on postoperative day 2, and symptoms resolved after pericardiocentesis. However, 20 h later, the patient underwent emergency surgery for re-developed acute cardiac tamponade, which was found to be a coronary tear. A review of the literature suggested that cardiac tamponade is more common in left lung surgery than right lung surgery. Pericardiocentesis can resolve initial acute cardiac tamponade, but pericardiotomy may be urgently needed after recurrence.
胸腔镜肺叶切除术是治疗肺癌的常用手术方法。随着手术技术和医疗器械的不断发展,胸腔镜肺叶切除术后的并发症越来越少,心脏压塞更是罕见。本例为 62 岁女性,因左肺上叶结节行胸腔镜左肺上叶切除术。术后第 2 天,患者发生急性心脏压塞,心包穿刺后症状缓解。但 20 小时后,患者因再次发生急性心脏压塞行急诊手术,发现为冠状动脉撕裂。文献复习提示心脏压塞在左肺手术中比右肺手术更常见。心包穿刺可以解决初始的急性心脏压塞,但复发后可能需要紧急行心包切开术。