Lobar torsion after pulmonary resection: Presentation and outcome

Cable, David G.; Deschamps, Claude; Allen, Mark S.; Miller, Daniel; Nichols, Francis C.; Trastek, Victor F.; Pairolero, Peter C.

doi:10.1067/mtc.2001.117839

Cited by 138 publications

(136 citation statements)

References 11 publications

(10 reference statements)

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“…These thrombi sometimes cause embolism to vital organs [8,11]. Lung resection, lobectomy, lung torsion, and lung transplantation have previously been reported as causes of PV thrombus [12][13][14][15]. There are two types of thrombus in the PV stump after lobectomy.…”

Section: Discussionmentioning

confidence: 99%

Thrombosis in the Pulmonary Vein Stump After Left Upper Lobectomy as a Possible Cause of Cerebral Infarction

Ohtaka

Hida

Kaga

et al. 2013

The Annals of Thoracic Surgery

127

180

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OBJECTIVE: Thrombus in the stump of the pulmonary vein (PV) is not a well-known complication after lung resection, and it has the potential to cause embolism to vital organs. To clarify the frequency, risk factors, and cause of this complication, a retrospective clinical study of patients who underwent lobectomy was performed.METHOD: The subjects were 193 patients with primary lung cancer who underwent lobectomy from 2005 to 2011 and contrast-enhanced chest CT within 2 years after lobectomy. Contrast-enhanced CT was retrospectively interpreted to check for thrombus in the PV stump.RESULTS: The operative procedures were 65 right upper lobectomies, 14 right middle lobectomies, 40 right lower lobectomies, 52 left upper lobectomies (LUL), and 22 left lower lobectomies. Of the 193 patients, 7 (3.6%) developed thrombus in the PV stump after lobectomy. All patients with thrombus had undergone LUL, and 13.5% of those who had undergone LUL developed thrombus. Univariate analyses revealed that LUL and operation time were significant risk factors, and that adjuvant chemotherapy was marginally significant. It appears that thrombus may be attributable to the length of the PV stump. Measurement of the length of the PV stump using three-dimensional CT images of the PV revealed that the stump of the left superior PV was longer than the others.CONCLUSION: Thrombus in the PV stump occurred in 13.5% of cases after LUL. These findings suggest that contrast-enhanced CT should be recommended for patients after LUL to help identify patients with a high risk for thromboembolism.(246 words)

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Section: Discussionmentioning

confidence: 99%

Thrombosis in the Pulmonary Vein Stump After Left Upper Lobectomy as a Possible Cause of Cerebral Infarction

Ohtaka

Hida

Kaga

et al. 2013

The Annals of Thoracic Surgery

127

180

View full text Add to dashboard Cite

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“…4 Contrast pulmonary angiography during helical CT scanning has the advantage of direct evidence of stenosis or complete obstruction of kinking vessels. 1 In our case, the chest radiograph on the fi rst postoperative day showed consolidation, but we did not suspect pulmonary torsion because the patient had no other symptoms. If we could have performed the bronchoscopy and chest CT on the fi rst postoperative day, resection of the lingula might not have been necessary.…”

Section: Discussionmentioning

confidence: 53%

Pulmonary torsion of the lingula following a segmentectomy of the left upper division

Eguchi

Katō

Shiina

et al. 2008

Gen Thorac Cardiovasc Surg

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We report a case of pulmonary torsion of the lingula. Thoracoscopic segmentectomy of the left upper division was performed on a 67-year-old woman. The chest radiograph on the first postoperative day showed consolidation in the left apical area. By the second postoperative day, the consolidation had increased in size. Bronchoscopy and chest contrast-enhanced computed tomography (CT) were conducted, and she was diagnosed with torsion of the lingula. We performed an emergency operation and resected the affected lung because of a gangrenous lobe. Although pulmonary torsion is a rare complication following lung resection, thoracic surgeons should always consider the risk. To prevent pulmonary torsion, we should confirm the correct position of the remaining lobes, and fixation of the lobes should be performed if there is little or no parenchymal bridge between contiguous lobes. A high index of clinical suspicion is necessary for early diagnosis, and rethoracotomy should be performed without delay.

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“…In addition, the patient's condition was complicated by intrathoracic hemorrhaging on the 8th postoperative day, and the fact that the patient's chest CT revealed torsion of the residual left lower lobe. Torsion of the left lower lobe is a rare complication of left upper lobectomy, 7,8 and was probably due to the unusual anatomical rotation of the hilum and postoperative overexpansion of the residual lower lobe. This torsion remitted spontaneously, but other unexpected complications due to anatomical abnormalities might develop in the early phase of the postoperative period.…”

Section: Discussionmentioning

confidence: 98%

Pulmonary resection for lung cancer with impaired pulmonary function due to severe spinal deformity: Report of a case

et al. 2011

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A 58-year-old man underwent surgery for the treatment of lung adenocarcinoma at our hospital. He had a history of spinal caries at the age of 3 and frequent recurrent asthma-like symptoms thereafter. Chest plain radiography revealed an irregularly shaped mass in the left hilum and a thoracic cage severely deformed by kyphosis. A pulmonary function test demonstrated a severe restrictive ventilation pattern. He underwent a left upper lobectomy without mediastinal dissection. His asthma-like symptoms were exacerbated by difficulty in expectoration of sputum for several days after surgery, but the symptoms disappeared without any medical care. Dyspnea, hemoptysis, and intrathoracic hemorrhage were observed on the 8th postoperative day. Computed tomography revealed torsion of the residual left lower lobe, but the symptoms spontaneously disappeared in a week. The patient had complained of frequent coughing and mild dyspnea on exertion for years, but his quality of life was unchanged after the lobectomy. Bone metastasis was detected 3 years after the surgery, and the patient then underwent chemotherapy. However, he died of the disease 4 years 2 months after the surgery.

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Lobar torsion after pulmonary resection: Presentation and outcome

Cited by 138 publications

References 11 publications

Thrombosis in the Pulmonary Vein Stump After Left Upper Lobectomy as a Possible Cause of Cerebral Infarction

Thrombosis in the Pulmonary Vein Stump After Left Upper Lobectomy as a Possible Cause of Cerebral Infarction

Pulmonary torsion of the lingula following a segmentectomy of the left upper division

Pulmonary resection for lung cancer with impaired pulmonary function due to severe spinal deformity: Report of a case

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