Correction of postpneumonectomy syndrome using a custom implant.
The authors describe a patient who underwent a right pneumonectomy for removal of a bronchial carcinoid tumour. Over time she developed recurrent infections, dyspnoea and wheeze despite no evidence of tumour recurrence. A marked mediastinal shift caused severe narrowing of the left main-stem bronchus as it was draped over the vertebral column consistent with a diagnosis of postpneumonectomy syndrome. Mediastinal reorientation was accomplished with the placement of two breast implants. Failure of the superior implant resulted in a recurrence of symptoms 4 months postoperatively. A durable custom expander with wall thickness three times that of a standard expander was placed after rupture of one of the two initially placed saline implants. At 2-years follow-up the patient has complete resolution of symptoms, without any further postoperative complications.
Department of Plastic and Reconstructive Surgery, University of Toronto Faculty of Medicine, The Banting Institute, Toronto, Canada.
Matthew C
MC
McRae
Frank C
FC
Detterbeck
Deepak
D
Narayan
D000328:Adult; D005260:Female; D006801:Humans; D011013:Pneumonectomy / Q000009:adverse effects*; D011183:Postoperative Complications / Q000601:surgery; D019736:Prostheses and Implants; D013577:Syndrome