Middle Lobectomy after Pneumonectomy

Abstract

A 59-year-old man underwent a successful middle lobectomy to treat metastasis from a pulmonary adenocarcinoma resected previously by left pneumonectomy.

Stereotactic body radiation therapy for a new lung cancer arising after pneumonectomy: dosimetric evaluation and pulmonary toxicity

“…Available data on surgical treatment of the second tumours after pneumonectomy are limited to small series [15][16][17][18][19][20][21][22][23][24][25] or case reports. [26][27][28] In 1-4 cm). The authors observed three deaths (25%) related to treatment, and six patients (50%) required chest tube placement for pneumothorax.…”

“…Surgery is even more arduous if the previous resection was pneumonectomy which usually has a significant negative impact on pulmonary reserve. Very few patients undergo additional resection after pneumonectomy, [15][16][17][18][19][20][21][22][23][24][25][26][27][28] and morbidity is not negligible. 20,23 Even a limited resection on the contralateral lung has a negative impact on pulmonary function.…”

Additional pulmonary resection after pneumonectomy under ECMO support: a narrative review and representative case report

“…In literature, less than 200 cases of pulmonary resections (lobectomies, segmentectomies, single and multiple wedge resections) after contralateral pneumonectomy were published (4,6,7,12,13,(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34). Most frequently, these were sublobar resections (especially wedge resections) and were performed by thoracotomy without the use of ECLS (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(32)(33)(34). Only a few case reports of ECMO-assisted pulmonary resection after contralateral pneumonectomy exist (4,6,12,13).…”

“…Evidence of small retrospectives case series suggest that surgery in the remaining lung is a reasonable and rewarding option for well-selected cases. Therefore, these patients should not generally be excluded from an additional surgical approach (4,6,7,12,13,(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)72).…”

“…Lobectomy may not always be feasible and is not recommended because of the possibility of severe impairment of pulmonary function and quality of life, with possible exception of a middle lobectomy or lingulectomy (only two lung segments) (19,23,24,26,69). Sublobar resection (segmentectomy or even wedge resection) is the preferred approach (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(32)(33)(34)69). Even if oncological principles might be compromised by the limited resection in high-risk patients with only a single lung, sublobar and preferably, non-anatomical resection might provide the best risk-benefit ratio with better pulmonary reserves and better quality of life (20,23,24,69).…”