Why the study?
Thrombus formation at the pulmonary vein transection site is more common in left upper lobectomy than other lobectomies.
Pulmonary vein thrombosis should be considered as a potential cause of late postoperative dyspnea following left upper lobectomy, and it can be effectively managed with anticoagulation.
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Late dyspnea after left-upper lobectomy may reflect PV-stump thrombosis; leaves open postop anticoagulation and epidural strategies.
BACKGROUND: Thrombus formation at the pulmonary vein transection site is more common in left upper lobectomy than other lobectomies. We report a case of dyspnea and contrast-enhanced computed tomography (CT) findings of pulmonary vein thrombosis after left upper lobectomy. CASE PRESENTATION: A 68-year-old man with left lung cancer underwent video-assisted thoracoscopic left upper lobectomy under general anesthesia with thoracic epidural analgesia. He had no postoperative complications and was discharged home on the 5th day postoperatively. He visited the outpatient clinic at 8 days after surgery because of dyspnea and underwent contrast-enhanced CT, which revealed a thrombus at the resected edge of the left upper pulmonary vein. Anticoagulation therapy was started. Thereafter, the thrombus shrank, and the patient's dyspnea improved. CONCLUSIONS: Left upper lobe resection is particularly associated with pulmonary venous thrombosis, and dyspnea due to pulmonary venous thrombus may develop late after surgery. Postoperative management methods such as anticoagulation and postoperative pain management should be reexamined.
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Kubo et al. (2022) studied this question.
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