title: Surgical treatment for severely damaged lung and pyothorax with bronchopleural fistula 9 years after induction chemoradiotherapy and bilobectomy.
abstract: Here, we present a 54-year old man 9 years after induction chemoradiotherapy and subsequent lower bilobectomy for Stage IIIA lung cancer suffering late complications of pyothorax and bronchopleural fistula in a severely damaged lung. Open-window thoracostomy and subsequent completion pneumonectomy via median sternotomy and anterior thoracotomy were performed. Although sternal wound infection required steel wire removal and debridement, with wound dressing at home, the patient could return to work. Late complications from infected treatment-damaged lungs need to be taken into consideration after induction chemoradiotherapy and subsequent surgery.
authors.affiliation: Department of Chest Surgery, Toho University Medical Center Omori Hospital, Tokyo, Japan. yoshinobuhata@hotmail.com
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Hata
authors.forename: Keigo
authors.initials: K
authors.lastname: Takagi
authors.forename: Hidenori
authors.initials: H
authors.lastname: Goto
authors.forename: Hajime
authors.initials: H
authors.lastname: Otsuka
mesh_terms: D001983:Bronchial Fistula / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D059248:Chemoradiotherapy / Q000009:adverse effects*; D016724:Empyema, Pleural / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006801:Humans; D055370:Lung Injury / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D008175:Lung Neoplasms / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000009:adverse effects*; D010995:Pleural Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D011013:Pneumonectomy / Q000009:adverse effects*; D011832:Radiation Injuries / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D012086:Reoperation; D016156:Respiratory Tract Fistula / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D012720:Severity of Illness Index; D056346:Sternotomy; D013907:Thoracostomy; D013908:Thoracotomy; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Completion pneumonectomy; Induction chemoradiotherapy; Lung cancer; Open-window thoracostomy; Severely damaged lung