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右下叶肺基底段异常体动脉供血(ABLL):术前栓塞与胸腔镜手术

Anomalous Systemic Arterial Supply to the Basal Segment of the Lung (ABLL) in the Right Lower Lobe: Preoperative Embolization and Thoracoscopic Surgery.

作者信息

Hatakeyama Takayuki, Homma Takahiro, Otsubo Kanji, Sakai Hiroki, Kimura Hiroyuki, Miyazawa Tomoyuki, Marushima Hideki, Kojima Koji, Saji Hisashi, Toyoda Natsumi, Sugiura Yoshiya, Ohike Nobuyuki

机构信息

Thoracic Surgery, St. Marianna University School of Medicine, Kawasaki, JPN.

Pathology, St. Marianna University School of Medicine, Kawasaki, JPN.

出版信息

Cureus. 2025 Apr 12;17(4):e82152. doi: 10.7759/cureus.82152. eCollection 2025 Apr.

Abstract

Anomalous systemic arterial supply to the basal segment of the lung (ABLL) is a rare congenital anomaly. Surgical resection is the standard treatment to prevent complications like hemoptysis. Right-sided ABLL, often characterized by longer and more complex vascular anatomy, poses a higher risk of bleeding. Preoperative planning and embolization techniques are crucial for successful surgical outcomes. This case of right-sided ABLL is presented to emphasize the importance of these strategies. A 55-year-old woman experienced right lower abdominal pain. Incidental findings on computed tomography revealed an abnormal vessel supplying segment 10 of the right lower lobe, diagnosed as ABLL. To minimize intraoperative hemorrhage, preoperative embolization with a vascular plug was performed. Video-assisted thoracoscopic surgery was subsequently undertaken. The aberrant artery was divided with an endoscopic stapler, and a wedge resection of the affected lung was performed. This case report demonstrates the benefits of combining embolization and surgical resection for right-sided ABLL. This approach would reduce the risk of intraoperative bleeding.

摘要

肺基底段异常体动脉供血(ABLL)是一种罕见的先天性异常。手术切除是预防咯血等并发症的标准治疗方法。右侧ABLL通常具有血管解剖结构更长且更复杂的特点,出血风险更高。术前规划和栓塞技术对于手术成功结果至关重要。本文介绍这例右侧ABLL病例,以强调这些策略的重要性。一名55岁女性出现右下腹痛。计算机断层扫描偶然发现一条异常血管供应右下叶第10段,诊断为ABLL。为尽量减少术中出血,术前用血管封堵器进行了栓塞。随后进行了电视辅助胸腔镜手术。用内镜吻合器切断异常动脉,并对患肺进行楔形切除。本病例报告证明了栓塞与手术切除相结合治疗右侧ABLL的益处。这种方法将降低术中出血风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/631e/12068357/cec139dc8f57/cureus-0017-00000082152-i01.jpg

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