[Lung cancer with an extrapericardial single trunk as the left pulmonary vein; report of a case].

A left lower lobectomy was successfully performed in a lung cancer patient with anatomical variation in which the left superior and inferior pulmonary veins were connected to the left atrium after forming an extrapericardial single trunk. This variation is surgically important because ligation and division of the left inferior pulmonary vein may result in blockage of upper lobe vein drainage at the time of a left lower lobectomy. The ligation of the pulmonary vein leads to severe lung edema, which may cause infection, respiratory distress, or postoperative complications that could be life-threatening. Surgeons must always pay attention to this variation when performing a left lower lobectomy.

[Congenital bronchial atresia treated with video-assisted thoracoscopic surgery; report of a case].

We report an adult case of congenital lobar emphysema due to bronchial atresia. A 24-year-old man was referred to our department because of cough and fever. A chest roentgenogram on admission showed multiple cystic shadows in the left lower lung field. Chest computed tomography (CT) demonstrated multiple cysts with neveau and scattered infiltration in the left lingual segment and lower lobe. Surgical treatment was scheduled because of no improvement of the chest lesions. The interlobar fissure was not found between the upper and the lower lobes, but between the upper and the lingual divisions. Additionally, the lingual bronchus was not bifurcated from the upper bronchus, but from the lower bronchus. As inflammatory changes were extended to the lingual division and the lower lobe, a left lingual segmentectomy and a lower lobectomy with video-assisted thoracoscopic surgery were performed. His postoperative course was uneventful and he was discharged at the seventh day after surgery.

[Duodenal metastasis from squamous cell carcinoma of the lung; report of a case].

Metastatic carcinoma from primary lung cancer is usually recognized in the brain, adrenal glands, and bone. It is uncommon in the digestive system, particularly in the duodenum. We report a 63-year-old man who had undergone a left lower lobectomy for lung cancer. Anemia (Hb 6.9 g/dl) had been observed 2 months after surgery for primary lung cancer. Gastroduodenoscopy showed duodenal metastasis, and further examination demonstrated adrenal metastasis. Palliative treatment was selected and the patient died 5 months after surgery.

[Right ventricular outflow tract reconstruction using a three-valved extracardiac conduit of expanded polytetrafluoroethylene vessel graft in the Ross operation: a pediatric case report].

A 16-year-old boy was diagnosed as having severe aortic regurgitation and moderate aortic stenosis due to congenital aortic bicuspid valve. A chest X-ray film showed the cardiothoracic ratio (CTR) of 64% and echocardiography revealed severe dilation of the left ventricular dimension with severe wall thickness. An electrocardiogram showed multiple ventricular arrhythmias. The patient underwent the Ross operation with the reconstruction between the right ventricle and the pulmonary arteries using a three-valved conduit which was made by an expanded polytetrafuloroethylene vessel graft. Ventricular arrhythmia disappeared just after the operation and left ventricular dimensions improved with the CTR of 53% except mild regurgitation of the neo-aortic valve three months later.