Abstract
We have reported the usefulness of the subxiphoid approach in thymectomy. However, such a new operation method may have unknown complications that rarely occur. Surgeons cannot completely avoid intraoperative and postoperative complications. We report a case of intraoperative injury of the orifice of the left internal thoracic vein flowing to the left brachiocephalic vein and postoperative pericarditis following video-assisted thoracic surgery (VATS) thymectomy. The innominate vein has been considered to be the vessel that is most frequently injured especially at the orifice of the thymic veins. We also suggest that the orifice of the left internal thoracic vein is the second dangerous location that requires special care. In addition, postoperative pericarditis occurred in this patient. Pericardial drainage was necessary. No additional complications have been found in the 9 months since the operation. Though VATS thymectomy using the subxiphoid approach is a safe and less-invasive operation, intraoperative and postoperative complications were possible to be occurred.
Highlights
We have reported the usefulness of the subxiphoid approach in thymectomy
We report a case of intraoperative injury of the orifice of the left internal thoracic vein flowing to the left brachiocephalic vein and postoperative pericarditis following video-assisted thoracic surgery (VATS) thymectomy
We recognized a small tear in the orifice of the left internal thoracic vein flowing into the innominate vein
Summary
We have reported the usefulness of the subxiphoid approach in thymectomy. we cannot completely avoid intraoperative and postoperative complications. We report a case of intraoperative injury of the orifice of the left internal thoracic vein flowing to the left brachiocephalic vein and postoperative pericarditis following VATS thymectomy. Case presentation A 48-year-old woman visited our hospital with a chief complaint of chest pain. She had experienced similar symptoms 3 weeks previously. The postoperative course was uneventful (Fig. 2a), and the chest drain was removed on the first postoperative day. The patient was discharged on the seventh postoperative day. This patient was readmitted on the 11th postoperative day because of palpitation and dyspnea. We diagnosed the patient with postoperative pericarditis (Fig. 2b), and 350 ml of diluted hemorrhagic
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