Double Sleeve Lobectomy with Pulmonary Artery Reconstruction with Autologous Pulmonary Vein Conduit Interposition for Centrally Located Squamous Cell Carcinoma

성용원, 오세진, 최재성, 문현종

서울특별시 보라매병원 흉부외과학교실

Background : Bronchial sleeve resection for centrally located primary lung cancer has been performed as a lung parenchyme-sparing operation in patients with poor lung function. When these centrally located tumors invade pulmonary artery, double sleeve lobectomy with pulmonary artery reconstruction has been performed using various types of prostheses, but there have been not many reports of using autologous pulmonary vein. We present a case of successful double sleeve lobectomy using an autologous pulmonary vein conduit.

Methods : A 73-year-old man was admitted with an incidentally detected left lower lung atelectasis. The chest computed tomograph scan and bronchoscopy revealed 3 cm sized left lower lobar (LLL) bronchial obstructing mass with suspicious pulmonary artery (PA) invasion. We performed double-sleeve left lower lobectomy which needed a reconstruction of lingular segmental PA. We divided LLL pulmonary vein as proximally as possible to obtain a PV conduit, and we performed lingular PA reconstruction by interposing this PV conduit.

Results : Pathologic result revealed a 4.8 cm sized squamous cell carcinoma with a single peribronchial lymph node metastasis. Postoperative pulmonary CT angio revealed patent left pulmonary artery flow without any narrowing sites. The patient is doing well 2 months after the operation without anticoagulation or antiplatelet agents.

Conclusion : Autologous pulmonary vein can be also considered for an effective prosthesis for pulmonary artery reconstruction. Long term follow up of oncologic results and patency is needed.

책임저자: 문현종

서울특별시 보라매병원 흉부외과학교실

연락처 : 문현종, Tel: 02-870-2292 , E-mail : moon730@medigate.net