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胸腔镜肺癌手术中舌叶静脉异常引流至左下肺静脉

Anomalous drainage of lingular vein into left inferior pulmonary vein during thoracoscopic lung cancer surgery.

作者信息

Guo Chenyang, Zhang Yadi, Zheng Haoqian, Wei Xing, Dai Wei, Li Qiang

机构信息

Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Graduate School, Chengdu Medical College, Chengdu, Sichuan, China.

Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, China.

出版信息

J Cardiothorac Surg. 2025 Jan 7;20(1):36. doi: 10.1186/s13019-024-03323-4.

Abstract

BACKGROUND

The intricate anatomical variations in lung structure often perplex thoracic surgeons, and the accurate identification of these variations is closely associated with favorable surgical outcomes.

CASE PRESENTATION

A 53-year-old female patient who underwent computed tomography (CT) examination due to chest discomfort, revealing the presence of a partial solid nodule highly suspected of early-stage lung cancer, measuring approximately 2.8 × 2.6 cm in the left lower lobe. Consequently, the patient underwent a single direction thoracoscopic left lower lobectomy and lymph node dissection. Intraoperatively, while attempting to dissect and free the left lower lobe vein from surrounding tissues, technical difficulties were encountered. Upon meticulous review of preoperative CT scans during surgery, an anomalous connection between the lingular vein of the left upper lobe and the left lower lobe vein was identified. Once this anatomical variation was confirmed, surgical intervention proceeded uneventfully without any significant complications.

CONCLUSION

Precise recognition of pulmonary anatomical structures before and during surgery is paramount in recognizing rare variations such as this one as it aids in preventing potential intraoperative injuries and minimizing postoperative complications.

摘要

背景

肺结构复杂的解剖变异常使胸外科医生感到困惑,准确识别这些变异与良好的手术结果密切相关。

病例介绍

一名53岁女性患者因胸部不适接受计算机断层扫描(CT)检查,发现左肺下叶有一个高度怀疑为早期肺癌的部分实性结节,大小约为2.8×2.6厘米。因此,该患者接受了单向胸腔镜下左肺下叶切除术及淋巴结清扫术。术中,在试图将左肺下叶静脉从周围组织中分离出来时遇到了技术困难。在手术过程中仔细复查术前CT扫描时,发现左上叶舌段静脉与左肺下叶静脉之间存在异常连接。一旦确认了这种解剖变异,手术顺利进行,未出现任何重大并发症。

结论

手术前和手术过程中对肺部解剖结构的精确识别对于识别此类罕见变异至关重要,因为这有助于预防潜在的术中损伤并将术后并发症降至最低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cba3/11705652/d0c938251ea5/13019_2024_3323_Fig1_HTML.jpg

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