左下葉摘出時に切離した肋骨による術後肺損傷

Lung Injuries Caused by a Cut Edge of a Rib after Thoracoscpic Lobectomy

われわれは，完全鏡視下手術（cVATS）で約7 cmの腫瘍を有する左下葉を切除後，検体を摘出する際に切離した肋骨断端により術後肺損傷をきたした症例を経験したため報告する．

A 73-year-old man was diagnosed with left lung cancer （cT3N0M0, stageⅡB）. Left lower lobectomy and lymph node dissection by complete video-assisted thoracic surgery （VATS） was planned. At surgery, removal of the left lower lobe thorough intercostal space was difficult, and the dissection of the left 5th rib was required. After surgery, air leak appeared and reoperation was performed. At second surgery, lung injuries caused by a cut edge of the left 5th rib were found. Both lung injuries and the dissected rib were repaired, and the postoperative course was uneventful.