Thrombus Formation in the Pulmonary Vein Stump after Left Upper Lobectomy: A Report of Four Cases
Thrombus Formation in the Pulmonary Vein Stump after Left Upper Lobectomy: A Report of Four Cases
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DOI：
10.5761/atcs.cr.13-00079
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发表时间：
2014-01-01
影响因子：
1.3
通讯作者：
Shiotani, Seiji
中科院分区：
文献类型：
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作者：
Ichimura, Hideo;Ozawa, Yuichiro;Shiotani, Seiji
左上肺叶切除术后可能会出现并发症，例如左上肺静脉残端（LSPV）形成血栓，这可能导致全身栓塞。我们遇到了 4 例此类病例，占我们机构进行的所有左上肺叶切除术的 3.4%。 4例中有1例出现右肾梗塞；其余病例无症状，只是通过增强计算机断层扫描（CT）偶然发现了血栓。术后发现血栓的时间从 4 天到 24 个月不等。即使在通过后外侧开胸术将上肺静脉（PV）分开的情况下，CT也显示残端在心包内足够长，足以形成血栓。所有病例均接受抗凝治疗，导致血栓消散。因此，当肺残端发现血栓时，应给予抗凝剂。
Left upper lobectomy may be followed by complications such as thrombus formation in a stump of the left superior pulmonary vein (LSPV), which may cause systemic embolization. We have encountered four such cases, which account for 3.4% of all left upper lobectomies performed at our institution. Right renal infarction was observed in one of these four cases; the remaining cases were asymptomatic, with the thrombus incidentally detected by enhanced computed tomography (CT). The postoperative duration for the detection of the thrombus varied from 4 days to 24 months. Even in a case in which the superior pulmonary vein (PV) was divided by posterolateral thoracotomy, CT showed that the stump was long enough intrapericardially for thrombus formation. Anticoagulant therapy was administered in all the cases, resulting in dissipation of the thrombus. Therefore, when a thrombus is detected in a pulmonary stump, an anticoagulant should be administered.