Postpneumonectomy syndrome after left lung resection.

Quillin, S P; Shackelford, Gary D.

doi:10.1148/radiology.179.1.2006258

Cited by 34 publications

(18 citation statements)

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“…Postpneumonectomy Syndrome.-Postpneumonectomy syndrome is a delayed complication seen primarily in children and young adults within a year after surgery (45)(46)(47). The syndrome is manifested in exertional dyspnea, inspiratory stridor, and recurrent pulmonary infections.…”

Section: Surgery-related Complicationsmentioning

confidence: 99%

Radiographic and CT Findings of Thoracic Complications after Pneumonectomy

Chae

Seo²,

Kim³

et al. 2006

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Pneumonectomy is the treatment of choice for bronchogenic carcinoma and intractable end-stage lung diseases such as tuberculosis and bronchiectasis, but it is often followed by postoperative complications, which account for significant morbidity and mortality. Knowledge of the radiologic features of such complications is of critical importance for their early detection and prompt management. Complications of pneumonectomy are classified as early or late, depending on when they occur in relation to the hospitalization period. Early complications of pneumonectomy include pulmonary edema, bronchopleural fistula, pneumonia of the contralateral lung, empyema, and adult respiratory distress syndrome, which may occur separately or in combination. Late postpneumonectomy complications include recurrent disease, infection, effects of radiation therapy or chemotherapy, and surgical complications such as late-onset bronchopleural fistula, postpneumonectomy syndrome, and esophagopleural fistula. Sequential examinations with chest radiography after pneumonectomy are an invaluable method of screening for these complications, especially in the early postoperative period. When the radiographic findings are inconclusive, computed tomography is helpful for establishing a diagnosis and obtaining detailed information about the disease process.

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Section: Surgery-related Complicationsmentioning

confidence: 99%

Radiographic and CT Findings of Thoracic Complications after Pneumonectomy

Chae

Seo²,

Kim³

et al. 2006

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“…Division of the ligamentum arteriosum, fixation of the aorta or pulmonary artery to the sternum, and placement of expandable stents have been described with varying outcomes. 7,[17][18][19][20] However, endoscopic bronchial stent insertion does not always enable adequate placement of a stent, and is usually applied in the presence of gross distortion. Moreover, with this treatment, the cause of compression of the main bronchus does not affect mediastinal displacement.…”

Section: Discussionmentioning

confidence: 99%

Management of post‐pneumonectomy syndrome using tissue expanders

et al. 2015

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BackgroundPost‐pneumonectomy syndrome (PPS) is a rare syndrome characterized by trachea‐bronchial stenosis and severe dyspnea. In this study, we retrospectively evaluated the clinical outcomes in patients who underwent placement of tissue expanders for PPS.MethodsData from patients who underwent placement of tissue expanders for PPS were analyzed for preoperative characteristics, surgical techniques, and postoperative outcomes. Between 1997 and 2014, a total of 10 patients were treated for PPS by tissue expanders.ResultsThe median age of the 10 patients was 45 years (range, 16–70). Four patients had undergone right pneumonectomy, three patients had undergone left pneumonectomy, and three patients had post‐pneumonectomy‐like syndrome. Preoperatively, seven patients initially received high oxygen therapy for hypoxemia but progressed to respiratory failure, and three patients required mechanical ventilator support. Among these three patients, one required intraoperative extracorporeal membrane oxygenation support because of sudden cardiac arrest during preparation for surgery. The median follow‐up was 59.5 months (range, 2–204). The median interval between pneumonectomy and repositioning was 13 months (range, 8–581). Two patients underwent placement of a single tissue expander, and two tissue expanders were placed in eight of the 10 patients. The median volume of tissue expanders inflated with saline was 450 cc (range, 60–850 cc) per tissue expander. There was no perioperative mortality in our study. Complications occurred in four patients (40%).ConclusionsRepositioning of the mediastinum with placement of a saline filled tissue expander for PPS is very effective for the relief of symptoms, with low mortality.

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“…It is caused by the negative pressure effect of the post-surgical hemithorax and overexpansion of the contralateral lung with resultant midline shift against fixed mediastinal structures. This is a delayed complication that primarily occurs in children, young adults, and women within one year of surgery, thought to be related to the increased elasticity of the lungs and mediastinum in these patients in contrast to those of older patients and men [71][72][73].…”

Section: Post-pneumonectomy Syndromementioning

confidence: 99%