title: A risk factor for kinked middle lobar bronchus following right upper lobectomy.
abstract: BACKGROUND
  Kinking of the middle lobar bronchus is sometimes observed after a right upper lobectomy, but prevention and treatment have not been established. This study aimed to determine the risk factors for a kinked middle lobar bronchus causing postoperative middle lobe atelectasis.
  
  
  METHODS
  We performed a retrospective analysis of the medical records of 35 patients who underwent a right upper lobectomy in our hospital. Demographic and preoperative variables were compared in 4 patients with postoperative middle lobe atelectasis and kinking of the middle lobar bronchus and 31 without postoperative middle lobe atelectasis, determined by bronchoscopy and computed tomography findings.
  
  
  RESULTS
  There were no significant differences between the two groups in terms of age, sex, body mass index, smoking status, lung function test results, or volume ratio of the right upper lobe. A shorter distance from the carina to the middle lobe orifice was the only risk factor for a kinked middle lobar bronchus identified (40.25 ± 2.45 vs. 48.06 ± 4.78 mm, p = 0.006).
  
  
  CONCLUSIONS
  A short distance from the carina to the middle lobe orifice could be a risk factor for kinking of the middle lobar bronchus in postoperative middle lobe atelectasis after right upper lobectomy.
authors.affiliation: Department of Thoracic Surgery, Kumamoto Chuo Hospital, Kumamoto, Japan yomokom19@gmail.com.
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Masuda
authors.affiliation: Department of Thoracic Surgery, Kumamoto Chuo Hospital, Kumamoto, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Marutsuka
authors.affiliation: Department of Thoracic Surgery, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Suzuki
mesh_terms: D000368:Aged; D001982:Bronchial Diseases / Q000175:diagnosis / Q000209:etiology*; D001999:Bronchoscopy; D005260:Female; D006801:Humans; D007564:Japan; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000009:adverse effects*; D011237:Predictive Value of Tests; D001261:Pulmonary Atelectasis / Q000175:diagnosis / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D014102:Torsion Abnormality / Q000175:diagnosis / Q000209:etiology*; D016896:Treatment Outcome
keywords: Lung; Pneumonectomy; Postoperative complications; Pulmonary atelectasis; Risk factors; Torsion abnormality