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三维计算机断层扫描重建用于右上叶异常静脉引流的术前诊断

3D Computed Tomography Reconstruction for Pre-Operative Diagnosis of Anomalous Venous Drainage of the Right Upper Lobe.

作者信息

Puca Maria Antonietta, Marella Antonio, Marvulli Maria, Rainone Anna, Capasso Francesca, di Filippo Vincenzo, Messina Gaetana, Fiorelli Alfonso

机构信息

Thoracic Surgery Unit, Department of Translational Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.

出版信息

Thorac Cancer. 2025 Jan;16(1):e15525. doi: 10.1111/1759-7714.15525.

Abstract

Anatomical variation of the pulmonary vessels poses challenges to thoracoscopic lung resection and may be associated with an increased risk of intraoperative bleeding and damage to pulmonary circulation. Herein, we reported a rare and dangerous variation as the partial anomalous venous drainage of the right upper lobe into the superior vena cava in a patient undergoing thoracoscopic lobectomy for management of lung cancer of right upper lobe. The preoperative identification of such variation by 3D computed tomography scan allowed to plan a safe and accurate resection, and to prepare additional strategies for overcome unexpected intraoperative bleeding. No intraoperative and/or postoperative complications were observed. Chest drainage was removed on postoperative day two and patient discharged the day after. At 3 months follow up, the patient was well without recurrence.

摘要

肺血管的解剖变异给胸腔镜肺切除术带来了挑战,可能会增加术中出血和肺循环损伤的风险。在此,我们报告了一例罕见且危险的变异情况,即一名因右上叶肺癌接受胸腔镜肺叶切除术的患者,其右上叶部分异常静脉引流至上腔静脉。术前通过三维计算机断层扫描识别这种变异,有助于规划安全、准确的切除手术,并为应对术中意外出血制定额外的策略。未观察到术中及术后并发症。术后第二天拔除胸腔引流管,患者于次日出院。随访3个月时,患者情况良好,无复发。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6158/11717039/47687d2b0a28/TCA-16-e15525-g003.jpg

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