A case of delayed completion pneumonectomy for bronchial deformation after upper lobectomy of the left lung

• Published in: Nihon Kokyuki Geka Gakkai zasshi (Kyoto, 1992) Vol. 20; no. 6; pp. 834 - 838
• Main Authors: Yodonawa, Satoshi, Ogawa, Isao, Fujiwara, Akira, Yoshida, Susumu, Goto, Yukinobu, Ito, Hiromichi, Kitahara, Miyuki
• Format: Journal Article
• Language: English
• Published: The Japanese Association for Chest Surgery 15.09.2006
• Subjects: bronchial deformation; completion pneumonectomy; left upper lobectomy
• ISSN: 0919-0945; 1881-4158
• DOI: 10.2995/jacsurg.20.834

We report a case of completion pneumonectomy for obstructive pneumonia with deformation of the lower bronchus after left upper lobectomy. A 73-year-old man had undergone left upper lobectomy for squamous cell lung cancer arising from B1+2 and the bronchial stump was closed using the Sweet method by hand-suturing. One year after the operation, he suffered from pneumonia of the residual left lobe. Bronchoscopic examination revealed stenosis of the basal truncus forming a slit deformation of the lower bronchus. He was readmitted to the hospital for pneumonia despite improvement with conservative medical treatment. Balloon dilation was not effective, the residual lobe was severely fibrotic and infection control became difficult. Therefore, the patient underwent left completion pneumonectomy eight years after the initial operation. Macroscopic observation of the resected specimen revealed protrusions of the bronchial cartilage wall and severe stenosis of the basal truncus as deformation of the lower bronchus. It was considered that in this case, the shortness of the bronchial stump with the Sweet method was the cause of the bronchial stenosis.