Rare isolated pulmonary resection with large vascular supply

Báo Thanh niênBáo Thanh niên09/01/2024


On January 9, information from Da Nang Hospital said that the hospital had just performed endoscopic surgery to remove part of the lower lobe of the left lung for a patient with a rare, large isolated lung in the lung.

Previously, patient VTT (58 years old, residing in Hoa Vang District, Da Nang City) went for a check-up and accidentally discovered a lesion in the lower lobe of the left lung. Through examination and chest CT scan, doctors discovered the image of this lesion located in the lower lobe of the left lung, nourished by an artery branch originating from the thoracic aorta.

The diameter of this feeding artery branch is half the diameter of the thoracic aorta. The patient was diagnosed with pulmonary sequestration in the lower lobe of the left lung and was indicated for surgery to remove the sequestered part of the lung by thoracoscopic method.

Doctors from the Department of Thoracic Surgery, Da Nang Hospital performed the surgery for 3 hours. Five days after the surgery, the patient was stable and discharged from the hospital.

Đà Nẵng: Phẫu thuật nội soi cắt bỏ phổi biệt lập có mạch nuôi lớn hiếm gặp- Ảnh 1.

VTT patient was discharged from hospital 5 days after surgery.

Dr. Than Trong Vu, Head of the Department of Thoracic Surgery, Da Nang Hospital, said that this was a rare case, a difficult and complicated surgery because the artery that nourishes the isolated lung in this patient had a large diameter, originating from the thoracic aorta, showing signs of calcification that could easily rupture and cause bleeding, so the doctors had to find a way to remove only the damaged part of the lung without removing the entire lobe of the patient's lung.

According to Dr. Vu, isolated lung is an abnormal congenital lesion in the lungs. This is a rare disease, congenital airway-lung malformation has an incidence rate of about 1/8,300 - 1/35,000 live births (ie 1 in 8,300 - 35,000 live births has congenital airway malformation). Among congenital airway-lung malformations, isolated lung accounts for 0.15 - 6.4%.

At Da Nang Hospital, there has only been one case of isolated lung in the past 10 years. Diagnosis of isolated lung is usually made in childhood. In adults, the detection of isolated lung without symptoms is very rare, only discovered by chance during diagnostic screening related to some diseases.

Đà Nẵng: Phẫu thuật nội soi cắt bỏ phổi biệt lập có mạch nuôi lớn hiếm gặp- Ảnh 2.

Doctors assess patient condition

According to Dr. Vu, the treatment of isolated lung is mainly surgical treatment to remove the non-functional part of the lung early. If the disease progresses with symptoms such as pneumonia or lung abscess, treatment will be more difficult, even requiring removal of the lobe of the lung containing the isolated lung, affecting the patient's respiratory function later.

"Therefore, patients who often have chest pain or recurrent pneumonia, when X-ray shows lesions below the rib cage, should suspect isolated lung lesions. From there, more in-depth tests such as chest CT scan with intravenous contrast injection should be performed to detect and treat isolated lung, avoiding complications that require lobar lung resection," Dr. Vu recommended.



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