低侵襲心臓手術後に発症した肺ヘルニアに対する胸壁再建の1例

Pulmonary Herniation Requiring Reconstructive Surgery Caused by Minimally Invasive Cardiac Surgery：Report of a Case

はじめに　肺ヘルニアは肺実質の一部が胸郭を越えて皮下に突出する比較的まれな疾患である1）．一方，低侵襲心臓手術（MICS）は肋間小開胸による心臓手術の方法であり，従来の胸骨正中切開よりも低侵襲に施行できることから近年増加傾向にある手技である2）．われわれは，MICSによる大動脈弁置換術後に発症した肺ヘルニアに対して胸壁再建を施行した1例を報告する．

A 72-year-old man who underwent aortic valve replacement by a minimally invasive cardiac surgery （MICS） approach two years ago was visited our hospital complaining of swelling and pain in the right anterior chest. A chest computed tomography （CT） scan showed that the right upper lobe protruded beyond the right second intercostal space and outside the thorax. He was diagnosed as a right intercostal lung hernia and underwent chest wall reconstruction with a substitute method. Postoperative course was uneventful without any evidence of recurrence. Postoperative intercostal lung hernias in MICS may increase with the increment in MICS, and it is necessary to accumulate cases as one of the complications.