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肺肿瘤切除术中锁骨下动脉损伤

Subclavian Artery Injury During Lung Tumor Resection.

作者信息

Umeda Yukio, Hagiwara Kiyohiko, Matsumoto Shinsuke

机构信息

Cardiovascular and Thoracic Surgery, Gifu Prefectural General Medical Center, Gifu, JPN.

出版信息

Cureus. 2024 Aug 26;16(8):e67846. doi: 10.7759/cureus.67846. eCollection 2024 Aug.

DOI:10.7759/cureus.67846
PMID:39347204
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11427703/
Abstract

An open penetrating injury of the subclavian artery is an extremely rare catastrophic situation in thoracic surgery. We experienced a 57-year-old case of iatrogenic subclavian artery injury during the resection of a lung tumor. The injury occurred during the dissection of the adhesion between the stapling site of the previous bullectomy and the chest wall. Systolic blood pressure dropped below 50 mmHg immediately after the injury. Following primary hemostasis achieved with suture closure, the site of injury was sufficiently exposed and successfully repaired.

摘要

锁骨下动脉开放性穿透伤在胸外科手术中是极其罕见的灾难性情况。我们遇到了一例57岁患者，在肺肿瘤切除术中发生了医源性锁骨下动脉损伤。损伤发生在先前肺大疱切除术吻合部位与胸壁之间粘连的分离过程中。损伤后收缩压立即降至50 mmHg以下。通过缝合关闭实现初步止血后，损伤部位得到充分暴露并成功修复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/95d1/11427703/f26c8f1d9c65/cureus-0016-00000067846-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/95d1/11427703/f642c0485488/cureus-0016-00000067846-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/95d1/11427703/d1b906c6e357/cureus-0016-00000067846-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/95d1/11427703/f26c8f1d9c65/cureus-0016-00000067846-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/95d1/11427703/f642c0485488/cureus-0016-00000067846-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/95d1/11427703/d1b906c6e357/cureus-0016-00000067846-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/95d1/11427703/f26c8f1d9c65/cureus-0016-00000067846-i03.jpg

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本文引用的文献

1
Iatrogenic giant subclavian artery pseudoaneurysm following clavicle fracture repair: A case report.锁骨骨折修复术后医源性巨大锁骨下动脉假性动脉瘤：一例报告。
Radiol Case Rep. 2023 Apr 29;18(7):2339-2342. doi: 10.1016/j.radcr.2023.03.045. eCollection 2023 Jul.
2
Endovascular treatment of axillosubclavian arterial injuries is a safe alternative to open repair.腋锁骨下动脉损伤的血管内治疗是开放修复的一种安全替代方法。
Am J Surg. 2022 Dec;224(6):1385-1387. doi: 10.1016/j.amjsurg.2022.10.034. Epub 2022 Oct 17.
3
Successful thoracoscopic management of iatrogenic left subclavian arterial injury: a case report.
胸腔镜成功治疗医源性左锁骨下动脉损伤：一例病例报告
J Thorac Dis. 2022 Jan;14(1):194-198. doi: 10.21037/jtd-21-1922.
4
Surgical Management of Subclavian and Proximal Axillary Artery Injuries.锁骨下动脉和近腋动脉损伤的外科治疗。
J Coll Physicians Surg Pak. 2021 Dec;31(12):1513-1515. doi: 10.29271/jcpsp.2021.12.1513.
5
Subclavian Artery Perforation and Mediastinal Hematoma Following Transradial Percutaneous Coronary Intervention.经桡动脉冠状动脉介入治疗后锁骨下动脉穿孔及纵隔血肿
JACC Case Rep. 2021 Jun 30;3(9):1206-1210. doi: 10.1016/j.jaccas.2021.05.009. eCollection 2021 Aug 4.
6
Clavicle fixation screw impingement causing subclavian artery pseudoaneurysm.锁骨固定螺钉撞击导致锁骨下动脉假性动脉瘤。
Radiol Case Rep. 2019 Jul 29;14(9):1148-1150. doi: 10.1016/j.radcr.2019.07.002. eCollection 2019 Sep.
7
Delayed subclavian artery rupture secondary to a traumatic first rib fracture.创伤性第一肋骨骨折继发锁骨下动脉延迟破裂
Trauma Case Rep. 2018 Aug 29;16:1-3. doi: 10.1016/j.tcr.2018.07.001. eCollection 2018 Aug.
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Fatal delayed rupture of the subclavian artery in a patient with first-rib fracture caused by blunt trauma.
Clin Case Rep. 2017 Jan 30;5(3):260-263. doi: 10.1002/ccr3.823. eCollection 2017 Mar.
9
Outcome comparison between open and endovascular management of axillosubclavian arterial injuries.腋-锁骨下动脉损伤开放手术与血管腔内治疗的疗效比较
J Vasc Surg. 2016 Mar;63(3):702-9. doi: 10.1016/j.jvs.2015.08.117. Epub 2015 Oct 23.
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Association between screw prominence and vascular complications after clavicle fixation.锁骨固定后螺钉突出与血管并发症之间的关联。
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