選択的肺葉ブロックを用いた肺切除の2例

There are cases in which one-lung ventilation is difficult due to contralateral lung resection or low lung function. Selective lobar blockade can improve oxygenation compared with one-lung ventilation and secure a good operative field by inducing partial collapse. We report two cases of lung resection involving selective lobar blockade. （Case１） An ８０-year-old female had previously undergone right upper and middle lobectomy for multiple lung tumors. Surgery was scheduled to remove a ７‐mm ground glass opacity from the upper left lobe. Oral intubation was performed （inner diameter of intubation tube：８mm）. Next, the left upper lobe bronchus was blocked with a７Fr Arndt blocker under bronchoscopy, and partial resection of the left upper lobe was conducted. （Case２） A ７５-year-old male had previously undergone right upper lobectomy for pulmonary tuberculosis and had developed right chronic empyema. Surgery was scheduled to remove a ２２-mm nodule from the left lingular segment. Oral intubation was performed（inner diameter of intubation tube：８．５mm）. Next, the left lingual bronchus was blocked with a７Fr Arndt blocker under bronchoscopy. Left lingular segmentectomy was carried out under thoracoscopic assistance. Intraoperative oxygenation was maintained in both cases, and the release of the block due to hypoxemia was not required in either case.