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Middle lobe suffering due to malposition and 180° tilt of the 2 remaining lobes after right upper lobectomy

Middle lobe (ML) suffering after right upper lobectomy (RUL) is rare but represents a major complication usually due to lobar torsion. We report 3 atypical consecutive cases of ML suffering due to malposition of the 2 remaining right lobes with a 180° tilt. All 3 female patients had surgery for non–...

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Autores principales: Janet-Vendroux, Aurelie, Al Zreibi, Charbel, Reverdito, Guillaume, Arame, Alex, Badia, Alain, Masmoudi, Hicham, Messaoudi, Houssem, Le Pimpec-Barthes, Francoise
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9976767/
https://www.ncbi.nlm.nih.gov/pubmed/36810693
http://dx.doi.org/10.1093/icvts/ivad038
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author Janet-Vendroux, Aurelie
Al Zreibi, Charbel
Reverdito, Guillaume
Arame, Alex
Badia, Alain
Masmoudi, Hicham
Messaoudi, Houssem
Le Pimpec-Barthes, Francoise
author_facet Janet-Vendroux, Aurelie
Al Zreibi, Charbel
Reverdito, Guillaume
Arame, Alex
Badia, Alain
Masmoudi, Hicham
Messaoudi, Houssem
Le Pimpec-Barthes, Francoise
author_sort Janet-Vendroux, Aurelie
collection PubMed
description Middle lobe (ML) suffering after right upper lobectomy (RUL) is rare but represents a major complication usually due to lobar torsion. We report 3 atypical consecutive cases of ML suffering due to malposition of the 2 remaining right lobes with a 180° tilt. All 3 female patients had surgery for non–small-cell carcinoma including RUL associated with radical hilar and mediastinal lymph node removal. Postoperative chest X-ray abnormalities appeared at days 1–3 respectively. The diagnosis of malposition of the 2 lobes was done on contrast-enhanced chest CT scan at days 7, 7 and 6, respectively. A reoperation for suspected ML torsion was required in all patients. Three repositionings of the 2 lobes and 1 middle lobectomy were performed. The postoperative courses were then uneventful, and the 3 patients were alive at a mean follow-up of 12 months. Before thoracic approach closure after RUL, systematic check of good positioning of the 2 reinflated remaining lobes is indispensable. It may prevent ML suffering secondary to 180° lobar tilt leading to whole pulmonary malposition.
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spelling pubmed-99767672023-03-02 Middle lobe suffering due to malposition and 180° tilt of the 2 remaining lobes after right upper lobectomy Janet-Vendroux, Aurelie Al Zreibi, Charbel Reverdito, Guillaume Arame, Alex Badia, Alain Masmoudi, Hicham Messaoudi, Houssem Le Pimpec-Barthes, Francoise Interdiscip Cardiovasc Thorac Surg Thoracic Oncology Middle lobe (ML) suffering after right upper lobectomy (RUL) is rare but represents a major complication usually due to lobar torsion. We report 3 atypical consecutive cases of ML suffering due to malposition of the 2 remaining right lobes with a 180° tilt. All 3 female patients had surgery for non–small-cell carcinoma including RUL associated with radical hilar and mediastinal lymph node removal. Postoperative chest X-ray abnormalities appeared at days 1–3 respectively. The diagnosis of malposition of the 2 lobes was done on contrast-enhanced chest CT scan at days 7, 7 and 6, respectively. A reoperation for suspected ML torsion was required in all patients. Three repositionings of the 2 lobes and 1 middle lobectomy were performed. The postoperative courses were then uneventful, and the 3 patients were alive at a mean follow-up of 12 months. Before thoracic approach closure after RUL, systematic check of good positioning of the 2 reinflated remaining lobes is indispensable. It may prevent ML suffering secondary to 180° lobar tilt leading to whole pulmonary malposition. Oxford University Press 2023-02-22 /pmc/articles/PMC9976767/ /pubmed/36810693 http://dx.doi.org/10.1093/icvts/ivad038 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Thoracic Oncology
Janet-Vendroux, Aurelie
Al Zreibi, Charbel
Reverdito, Guillaume
Arame, Alex
Badia, Alain
Masmoudi, Hicham
Messaoudi, Houssem
Le Pimpec-Barthes, Francoise
Middle lobe suffering due to malposition and 180° tilt of the 2 remaining lobes after right upper lobectomy
title Middle lobe suffering due to malposition and 180° tilt of the 2 remaining lobes after right upper lobectomy
title_full Middle lobe suffering due to malposition and 180° tilt of the 2 remaining lobes after right upper lobectomy
title_fullStr Middle lobe suffering due to malposition and 180° tilt of the 2 remaining lobes after right upper lobectomy
title_full_unstemmed Middle lobe suffering due to malposition and 180° tilt of the 2 remaining lobes after right upper lobectomy
title_short Middle lobe suffering due to malposition and 180° tilt of the 2 remaining lobes after right upper lobectomy
title_sort middle lobe suffering due to malposition and 180° tilt of the 2 remaining lobes after right upper lobectomy
topic Thoracic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9976767/
https://www.ncbi.nlm.nih.gov/pubmed/36810693
http://dx.doi.org/10.1093/icvts/ivad038
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