A case of thrombosis in the left superior pulmonary vein stump after left upper lobectomy

Abstract

Thrombus formation in the pulmonary vein stump is a potentially lethal complication after anatomic lung resection, especially after resection of the left upper lobe of the lung. A long left superior pulmonary vein (LSPV) stump is one of the causes of thrombosis in the pulmonary vein stump. A 69-year-old man was admitted to our hospital with an abnormal shadow on a screening chest radiograph. Bronchial biopsy and brushing confirmed squamous cell carcinoma. The patient underwent left upper lobectomy with systematic lymph node dissection, with a final diagnosis of pT3N0M0-IIB, pm1. To prevent thrombus formation in the pulmonary vein stump, we divided the LSPV to be as short as possible in the pleural space. The patient was prescribed adjuvant chemotherapy consisting of 3 cycles of CDDP+GEM. Enhanced computed tomography (CT) revealed a thrombus in the stump of the LSPV 7 months after surgery. Anticoagulant therapy was immediately initiated. Enhanced CT performed 3 months later revealed that the thrombus in the stump of the LSPV had disappeared. We suggest that creating an LSPV stump that is as short as possible is insufficient to prevent thrombus formation in the stump.