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ABSTRACT: Postpneumonectomy syndrome is characterized by postoperative bronchial obstruction caused by mediastinal shift. The syndrome is well documented in the medical literature as a late complication of right pneumonectomy; however, it rarely occurs following resection of the left lung, and only 10 cases have been published. The pathophysiology, clinical manifestations, prognosis, and treatment are similar for both sides of the lung. We present the case of an adult patient who underwent left pneumonectomy and developed postpneumonectomy syndrome 15 months later. Stenosis of the intermediate bronchus occurred between the vertebral body and the right pulmonary artery. Endoscopic treatment with a self-expanding metal stent was successful, and complete remission was observed over the 6 months of follow-up.
Archivos de Bronconeumología 07/2009; 45(12):617-9. · 2.17 Impact Factor
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Medicina Clínica 05/2009; 132(15):607. · 1.38 Impact Factor
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Julio Sánchez de Cos Escuín,
Luis Miravet Sorribes,
José Abal Arca, Ana Núñez Ares,
Jesús Hernández Hernández,
Ana M Castañar Jover,
Francisco Javier Muñoz Gutiérrez,
Luis García Arangüena,
Miguel Angel Alonso,
M Carmen Montero Martínez,
Jesús Allende González,
Ignacio Sánchez Hernández
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ABSTRACT: Mortality due to lung cancer in Spain is increasing continuously. The aim of the present study was to collect information on the hospital incidence of lung cancer, as well as information on clinical management, in different regions of Spain.
A prospective observational study of patients diagnosed with lung cancer in 2003 was carried out in 13 centers in 9 autonomous communities. Epidemiological, clinical, diagnostic, and therapeutic variables were assessed.
Of a total population of 2,726,601 inhabitants (1 346 483 men and 1 380 118 women), 1064 male and 125 female lung cancer patients were included. The incidence standardized to the world population varied between 42.4/100,000 and 61.8/100,000 in men and between 1.5/100,000 and 8.6/100,000 in women. Overall, 51% were aged over 70 years, and 97.5% of the men and 32% of the women were smokers or ex-smokers. Cytologic or histologic confirmation was obtained for 93.1% of the cases (20.8% of which were small cell lung cancers and 79.2% were non-small cell lung cancers). The main initial symptoms were cough, chest pain, and weight loss. In 13.7%, lung cancer was suspected because of abnormal chest x-ray. The percentage with clinical TNM stages I and II ranged from 6.3% to 26.9%. The most common stage was stage IV in all centers. The percentage of patients undergoing surgery ranged from 2.5% to 20.6%, with a mean of 14.8% (19.9% of whom were patients with non-small cell lung cancer); 27% received palliative treatment only.
The proportion of women suffering from lung cancer increased with respect to previous studies, with notable differences among regions. Despite diagnostic improvements, the percentage of patients undergoing surgery is low, though interregional variation is considerable.
Archivos de Bronconeumología 10/2006; 42(9):446-52. · 2.17 Impact Factor
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ABSTRACT: Postpneumonectomy syndrome is characterized by postoperative bronchial obstruction caused by mediastinal shift. The syndrome is well documented in the medical literature as a late complication of right pneumonectomy; however, it rarely occurs following resection of the left lung, and only 10 cases have been published. The pathophysiology, clinical manifestations, prognosis, and treatment are similar for both sides of the lung.We present the case of an adult patient who underwent left pneumonectomy and developed postpneumonectomy syndrome 15 months later. Stenosis of the intermediate bronchus occurred between the vertebral body and the right pulmonary artery. Endoscopic treatment with a self-expanding metal wallstent was successful, and complete remission was observed over the 6 months of follow-up.ResumenSe entiende por síndrome posneumonectomía la obstrucción bronquial postoperatoria, causada por un desplazamiento exagerado del mediastino. Este síndrome está bien documentado en la literatura médica como complicación tardía de una neumonectomía derecha, pero su producción tras una resección del pulmón izquierdo es excepcional, pues apenas se ha publicado una decena de casos. La fisiopatología, las manifestaciones clínicas, el pronóstico y el tratamiento son similares para ambos lados.Presentamos el caso de un paciente adulto a quien se practicó una neumonectomía izquierda y que desarrolló un síndrome posneumonectomía a los 15 meses del postoperatorio. La estenosis del bronquio intermediario se produjo entre el cuerpo vertebral y la arteria pulmonar derecha. Se efectuó eficazmente tratamiento endoscópico con una prótesis metálica autoexpandible, con lo cual se observó la remisión completa de los síntomas durante los 6 meses de seguimiento.
Archivos de Bronconeumología ((English Edition)).
