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Vol.60 No.2 contents | Japanese/English |
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- Case Report -
A Surgical Case of Lung Cancer Complicated with Spinocerebellar Degeneration with Safe Perioperative Management
Akihiro Yonei1, Hirokazu Moriyama11Department of Respiratory Surgery, Miyazaki Zenjinkai Hospital, Japan
Background. Patients with spinocerebellar degeneration (SCD) may have stenosis of the glottis due to ablation of the vocal cords. Therefore, there is a risk that airway stenosis may appear and worsen after general anesthesia, and caution is required. Case. The patient was a 68-year-old male who developed SCD five years before his first visit. A nodule shadow was noted in the upper left lung field on preoperative chest X-ray for the left ingrown nail of our hospital orthopedic surgery. Bronchoscopy was performed, but no definitive diagnosis was made. However, because chest CT findings suggested lung adenocarcinoma, we planned a radical operation with an intraoperative diagnosis. Because a diagnosis of adenocarcinoma was obtained by a rapid needle biopsy during the operation, thoracoscopic left upper division segmentectomy was performed. Since vocal cord dysfunction in SCD cases carries a risk of sudden death after surgery, the preoperative evaluation of the disease type is important. In this case, we confirmed there to be no vocal cord movement disorder by bronchoscopy before and after surgery. Conclusion. In SCD patients, a careful perioperative airway evaluation during the perioperative period and measures for cannot ventilate and cannot intubate (CVCI) cases are considered crucial for safe perioperative management.
key words: Spinocerebellar degeneration, Primary lung cancer, General anesthesia, Separate lung ventilation
Received: November 21, 2019
Accepted: January 22, 2020
JJLC 60 (2): 120-124, 2020
