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The Japanese Journal of Thoracic Surgery Volume 71, Issue 8 （August 2018）

胸部外科 71巻8号（2018年8月発行）

Japanese English

今月の話題

縦隔型肺底区動脈を有する肺癌に対する気管支形成を伴う左上葉切除 Wedge Bronchoplastic Left Upper Lobectomy for Lung Cancer Patient with Abnormal Mediastinal Left Basal Pulmonary Artery 八柳英治 ¹ , 安田俊輔 ¹ Eiji Yatsuyanagi ¹ , Shunsuke Yasuda ¹ ¹帯広病院呼吸器外科 ¹Department of General Thoracic Surgery, National Obihiro Hospital キーワード：肺動脈 , 分枝異常 , 縦隔型肺底区動脈 , 3D-CT Keyword: pulmonary artery , abnormal branching , mediastinal basal pulmonary artery , three-dimensional computed tomography pp.573-577

発行日 2018年8月1日 Published Date 2018/8/1

DOI https://doi.org/10.15106/j_kyobu71_573

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肺血管の分枝は多彩で，肺癌根治術を行う際には注意を要する．われわれはA9＋10が左肺動脈の第1枝として分枝した肺癌例を経験し，この分枝異常を術前3D-CTで把握し，安全に左上葉切除術を施行しえたので報告する．

A 65-year-old man with left lung squamous cell carcinoma was admitted to our hospital for operation. His tumor was located left upper lobe and invaded to the orifice of left upper bronchus. We diagnosed the tumor as cT2aN0M0 and intended to perform radical operation. Preoperative three-dimensional computed tomography （3D-CT） revealed that A9＋10 which descended along lower bronchus was arisen from the left main pulmonary artery as a 1st branch of it. A wedge bronchoplastic left upper lobectomy was safely done with preserving the branch. Although this abnormal branching of left pulmonary artery is very rare, we should pay more attention this type of anomaly because unintended injury of the branch causes massive bleeding or ischemia of left lower lobe. Preoperative 3D-CT is useful for detecting the anomaly of pulmonary vessels.