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Venous concerns after lingula sparing left upper lobectomy.

Chloé Lafouasse¹, Dominique Gossot¹, Agathe Seguin-Givelet^1,2

¹Thoracic Surgery Department, Thorax Institute-Curie-Montsouris, Paris, France.

Interdisciplinary Cardiovascular and Thoracic Surgery

|June 6, 2023

Summary

This summary is machine-generated.

Postoperative lingula ischemia after lung surgery is often wrongly blamed on twisting. Reoperation cases reveal that venous issues, not torsion, are the primary cause of this complication.

Keywords:

Left upper trisegmentectomy Lingula Lingular ischaemia Lingular torsion

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Laparoscopic Left Hemihepatectomy Combined with Caudate Lobe Resection

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Area of Science:

Thoracic Surgery
Surgical Complications
Pulmonary Anatomy

Background:

Postoperative lingula ischemia is a known complication following left upper lobe trisegmentectomy.
It is typically attributed to torsion of the remaining lingula.
However, other factors like venous interruption may also contribute.

Purpose of the Study:

To investigate the causes of postoperative lingula ischemia in patients undergoing reoperation after lingula-sparing left upper lobectomy.
To determine if torsion is the primary cause or if other factors are involved.

Main Methods:

Retrospective review of 3 cases requiring reoperation for suspected lingula ischemia post-lung surgery.
Analysis of surgical findings during reoperation to identify the cause of ischemia.

Main Results:

None of the 3 reoperation cases were found to be caused by lingula torsion.
In all cases, the ischemia was linked to accidental injury of the lingular venous drainage or an abnormal venous pattern.

Conclusions:

Lingula ischemia after lung surgery is not primarily caused by torsion.
Accidental injury to lingular venous drainage or unusual venous anatomy are the likely culprits.
This highlights the importance of careful surgical technique regarding lingular vasculature.