2020 Volume 34 Issue 1 Pages 52-56
A 69-year-old man presented to our hospital with a chest nodule that was incidentally detected on computed tomography. The patient was pathologically diagnosed with lung cancer by transbronchial lung biopsy. The patient had a history of esophageal cancer treatment by chemoradiation therapy using proton-beam irradiation followed by salvage esophagectomy. Since the radiation field covered not only the mediastinum but also the left hilar pulmonary vessels and bronchus, and the patient showed malnourishment (BMI=15.6 kg/m2) and diabetes mellitus, the high risk of a bronchopleural fistula was considered in addition to the complication of severe fibrosis. Therefore, left upper division segmentectomy was selected as the operative method. The procedure was completed successfully with appropriate care, such as taping the left pulmonary artery trunk before resection of vessels, and covering the bronchial stump with a pedicled latissimus dorsi muscle flap. The postoperative course was excellent, and no relapse of lung cancer was detected for a year after surgery.
