2023 Volume 37 Issue 4 Pages 185-191
The patient was a 52-year-old man who underwent a thoracoscopic left lower lobectomy and two partial left upper lobe resections at a previous hospital for colorectal cancer metastasis. He was admitted to our hospital due to recurrence in the surgical margin. The images showed that the recurrent tumor and lung resection line were in close contact. Furthermore, considering that the mediastinal pleura surrounding the aorta had been resected at the time of the previous surgery, it was determined that the recurrent site had infiltrated or adhered to the aortic wall. An aortic stent graft was inserted before lung resection so that it could be performed safely. Although marked adhesions between the S1+2 segment and descending aorta were observed intraoperatively, as expected, we were able to safely dissect the aortic stent and resect the S1+2 segment as planned. The patient was discharged on postoperative day 14. After one and a half months, he was knocked over by a dog and developed back pain. On CT, the patient was found to have Stanford type B acute aortic dissection, the entry of which was at the proximal end of the aortic stent graft. He improved with conservative treatment and blood pressure control. From our above-mentioned experience, the risks and benefits of preoperative aortic stent graft placement need to be carefully examined in lung surgery.
