title: Bronchial obstruction by tumor embolus of contralateral lung during pneumonectomy: report of a case.
abstract: Bronchial obstruction due to a tumor embolus of the contralateral lung during pneumonectomy is an uncommon and fatal complication. According to previous cases, a bronchial balloon of double-lumen endotracheal tube (DLT) could prevent a dislodged tumor from traveling to the contralateral lung. We experienced a tumor embolism from the bronchus with cancer to the other bronchus despite applying DLT. A 59-year-old male with endobronchial lung cancer underwent a left pneumonectomy. One-lung ventilation was established by the right-sided DLT. After a left bronchial division, a sudden increase of peak airway pressure and reduction of the expired tidal volume to 50 ml was observed. Intraoperative fiberoptic bronchoscopy showed a near total obstruction of the right main bronchus due to tumor emboli. It was not possible to remove the tumor embolus through bronchoscopic suction and forceps. Therefore, we reopened the left bronchial stump and successfully extracted tumor embolus under bronchoscopic guidance.
authors: Department of Anesthesiology and Pain medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea.
authors: Dong Kyu
authors: DK
authors: Lee
authors: Heezoo
authors: H
authors: Kim
authors: Sang Ho
authors: SH
authors: Lim
authors: Young Ho
authors: YH
authors: Choi
authors: Hyun Koo
authors: HK
authors: Kim
mesh_terms: D000402:Airway Obstruction / Q000209:etiology* / Q000601:surgery*; D001980:Bronchi / Q000473:pathology / Q000601:surgery; D001984:Bronchial Neoplasms / Q000601:surgery*; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation / Q000379:methods; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D011013:Pneumonectomy / Q000009:adverse effects*