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肺癌手术后自发性冠状动脉破裂:一例病例报告及文献复习

Spontaneous coronary artery rupture after lung cancer surgery: A case report and review of literature.

作者信息

Ruan Ying-Ding, Han Jian-Wei

机构信息

Department of Thoracic Surgery, The First People's Hospital of Jiande, Jiande 311600, Zhejiang Province, China.

出版信息

World J Cardiol. 2024 Feb 26;16(2):92-97. doi: 10.4330/wjc.v16.i2.92.

Abstract

BACKGROUND

Spontaneous coronary artery rupture (SCAR) is a rare and life-threatening complication after lung cancer surgery. We present a case of SCAR following left upper lobectomy, successfully managed through emergency thoracotomy and coronary artery ligation.

CASE SUMMARY

A 61-year-old male patient underwent left upper lobectomy and mediastinal lymph node dissection for lung cancer. The surgery was performed using single-port video-assisted thoracoscopic surgery, and there were no observed complications during the procedure. However, 19 h after surgery, the patient experienced chest discomfort and subsequently developed severe symptoms, including nausea, vomiting, and a drop in blood pressure. Urgent measures were taken, leading to the diagnosis of SCAR. The patient underwent emergency thoracotomy and coronary artery ligation, successfully stopping the bleeding and stabilizing the condition. Despite postoperative complications, the patient made a successful recovery and was discharged from the hospital.

CONCLUSION

SCAR is a rare but life-threatening complication following lung cancer surgery. Immediate thoracotomy has been shown to be a life-saving measure, while stenting is not the preferred initial approach.

摘要

背景

自发性冠状动脉破裂(SCAR)是肺癌手术后一种罕见且危及生命的并发症。我们报告一例左上叶切除术后发生SCAR的病例,通过急诊开胸手术和冠状动脉结扎成功处理。

病例摘要

一名61岁男性患者因肺癌接受了左上叶切除术和纵隔淋巴结清扫术。手术采用单孔电视辅助胸腔镜手术,术中未观察到并发症。然而,术后19小时,患者出现胸部不适,随后出现严重症状,包括恶心、呕吐和血压下降。采取了紧急措施,诊断为SCAR。患者接受了急诊开胸手术和冠状动脉结扎,成功止血并稳定了病情。尽管术后出现并发症,但患者恢复良好并出院。

结论

SCAR是肺癌手术后一种罕见但危及生命的并发症。急诊开胸手术已被证明是一种挽救生命的措施,而支架置入术并非首选的初始治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa24/10915888/20fb18323b16/WJC-16-92-g003.jpg

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