[右上叶肺癌切除术伴支气管移位和肺静脉异常]。

Q4 Medicine Kyobu geka. The Japanese journal of thoracic surgery Pub Date : 2024-03-01
Ryotaro Katsuya, Keiyu Sato, Junzo Ishida, Ryo Yamashita
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引用次数: 0

摘要

患者是一名 77 岁的男性。他在胸部计算机断层扫描(CT)中发现右肺顶有一个 6.5 厘米大小的肿块,随后被转诊到我院。支气管镜检查显示为腺癌,临床分期为ⅡB,患者被转诊至我院接受手术治疗。术前三维计算机断层扫描(3D-CT)显示,右主支气管从上叶支气管向中央分支,存在一条移位的支气管(可能是 B1a),一条异常血管(V2)从上叶支气管和右主支气管背侧穿过,直接返回左心房。手术通过后外侧切口切除右上叶,合并切除壁胸膜和淋巴结清扫(ND2a-2)。由于肺癌手术有时会伴有支气管和肺血管分支异常,因此手术前必须通过支气管镜和 3D-CT 彻底检查患者的异常分支。
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[Resected Right Upper Lobe Lung Cancer with Displaced Bronchus and Anomalous Pulmonary Vein].

The patient is a 77-year-old man. He was referred to our hospital after a chest computed tomography (CT) scan revealed a 6.5 cm-sized mass in the right lung apex. Bronchoscopy revealed adenocarcinoma, clinical stageⅡB, and the patient was referred for surgery. Preoperative 3D-CT revealed the presence of a displaced bronchus, probably B1a, branching from the right main bronchus centrally from the upper lobe bronchus, and an abnormal vessel (V2) running dorsal to the upper lobe bronchus and the right main bronchus, and returning directly to the left atrium. Surgery was performed by resectioning the right upper lobe through a posterolateral incision, combined resection of the wall pleura, and lymph node dissection (ND2a-2). Because lung cancer surgery is sometimes accompanied by abnormal bronchial and pulmonary vascular branches, it is essential to thoroughly examine the patient before surgery for checking abnormal branches by bronchoscopy and 3D-CT.

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