左肺静脈共通幹誤切断後の左下肺静脈血行再建

Left Upper Lobectomy Followed by Left Lower Pulmonary Vein Reconstruction after Miscutting the Common Trunk of the Left Pulmonary Veins

肺静脈共通幹は上肺静脈と下肺静脈が共通幹を形成し，左房へ還流する肺血管走行変異である．肺葉切除において肺静脈共通幹を誤切断した場合は致死的合併症を生じうる．われわれは，左上葉切除において肺静脈共通幹を左上肺静脈と誤認して切断したものの，左下肺静脈の血行再建により左下葉を温存できた症例を経験したので，手術手技および術後の管理について報告する．

A 65-year-old woman was diagnosed with lung cancer on the left upper lobe. During thoracoscopic left upper lobectomy, the common trunk of pulmonary vein was mistaken for the left upper pulmonary vein and divided incorrectly. Instead of left pneumonectomy, we successfully performed pulmonary vein reconstruction. As a result of anticoagulant therapy for 1 month, postoperative course was uneventful.