How to optimize the treatment strategy for patients of pulmonary sequestration with an elevated risk of fatal hemorrhage during operation: case discussion
| Autor: | Kyoji Hirai, Mateusz Polaczek, Hongxu Liu, Zhanwu Yu, Pingwen Yu, Atsushi Ito, Yu Liu, Michel Gonzalez |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
iMDT Corner
Pulmonary and Respiratory Medicine medicine.medical_specialty business.industry Optimal treatment 030204 cardiovascular system & hematology medicine.disease Safe handling Surgery Pulmonary sequestration 03 medical and health sciences Pulmonary sequestrations atherosclerosis case report hemorrhage 0302 clinical medicine medicine.anatomical_structure 030228 respiratory system Aberrant artery medicine.artery Medicine Thoracic aorta Treatment strategy business Case discussion Artery |
| Zdroj: | Journal of thoracic disease, vol. 12, no. 8, pp. 4450-4458 J Thorac Dis |
| Popis: | Video-assisted thoracoscopic surgery (VATS) lobectomy, especially uniportal VATS, is increasingly used for pulmonary sequestration (PS). However, there are few descriptions of safe handling of the aberrant artery with atherosclerosis, especially the diameter of arteries exceeds than 2.0 cm, under uniportal VATS approach. Here we report a 56-year-old man who was diagnosed with pulmonary sequestration following trauma. The patient had a long history of cough with purulent sputum. One month before the trauma, he had copious expectoration with foul smell again. A contrast CT scan revealed a 7.5 cm mass in his right lower lobe. The mass was supplied by a thick aberrant atherosclerotic artery (over than 2 cm in diameter), which stemmed from the thoracic aorta with multiple calcifications on both. After adequate preoperative evaluation, we performed a right lower lobectomy under uniportal VATS approach. No surgical-associated complications occurred, and the patient was discharged on the 5th days after the operation. We organized an iMDT (international multidisciplinary team) to discuss the reasonability and optimal treatment pattern for this patient. We found that fully assess the quality of the aberrant arteries of PS following blocking and cutting off in an appropriate way are crucial to avoid the happening of fatal bleeding during the operation. |
| Databáze: | OpenAIRE |
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