左側肺癌手術中の心停止

Cardiac Arrest During Thoracic Surgery for Left Lung Cancer

肺癌手術では肺門部での胸膜の牽引や心臓への圧迫により，循環器系への負荷を強いることがある．迷走神経刺激に起因すると思われる心停止を起こすこともあり，注意を要する．われわれは左肺上葉切除術後の縦隔リンパ節郭清中に心停止を起こした症例を経験したので報告する．

A 69-year-old man was referred to our hospital due to an abnormal chest shadow on computed tomography （CT） scan. He underwent thoracoscopic left upper lobectomy followed by mediastinal lymph node dissection under the frozen-section diagnosis of lung cancer. During the left upper mediastinal lymph-node dissection, grasping fat tissue including cardiac branches of the vagus nerve led to cardiac arrest. It is known that left-side upper mediastinal lymph-node dissection can potentially trigger cardiac arrest. Therefore, it is crucial to proceed surgery with caution and to alert anesthesiologists to pay an attention to the risk of cardiac arrest.