Late sequelae of lobectomy for primary lung cancer: fibrobullous changes in ipsilateral residual lobes.
BACKGROUND
Late complications after lobectomy for primary lung cancer are rare. Progressive fibrobullous changes in the ipsilateral residual lobes were observed in some of the long-surviving patients after lobectomy for lung cancer. We report clinical details of this late complication.


METHODS
Between 1975 and 1997, we selected 39 patients (35 males and 4 females) from a total of 1321 patients who underwent lobectomy for primary lung cancer.


RESULTS
The incidence rate of this complication was 3%; this increased to 5.6% in patients who had survived for 5 years or more. A chest roentgenogram revealed fibrobullous changes on an average of 2.5 years (range 3 months-6 years) after lobectomy; these changes progressed throughout the ipsilateral lobes over several years. Ten patients (26%) required continuous oxygen therapy. The fibrobullous lungs of 21 (54%) patients were infected with nontuberculous mycobacterium, aspergillus, methicillin-resistant Staphylococcus aureus, and unidentified bacteria in 5, 4, 1, and 11 patients, respectively. Twenty-four patients died of the following causes: cancer (8, 33%), respiratory failure and chronic infections related to this complication (10, 42%), and other diseases (6, 25%). Three patients underwent successful surgical intervention for treating chronic infection of the destroyed lungs (omentopexy 1, completion pneumonectomy 2).


CONCLUSIONS
Fibrobullous lung should be recognized as an important late complication that develops in lung cancer patients after lobectomy.
Tanaka
Hisaichi
H
Department of Surgery, National Hospital Organization Kinki-chuo Chest Medical Center, 1180 Nagasonechou, Sakai, Osaka 591-8555, Japan. h-tanaka@kch.hosp.go.jp
Matsumura
Akihide
A
Ohta
Mitsunori
M
Ikeda
Naoki
N
Kitahara
Naoto
N
Iuchi
Keiji
K
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009894:Opportunistic Infections / Q000150:complications; D011013:Pneumonectomy / Q000009:adverse effects* / Q000379:methods; D011379:Prognosis; D011658:Pulmonary Fibrosis / Q000000981:diagnostic imaging / Q000209:etiology*; D012141:Respiratory Tract Infections / Q000150:complications; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed