Thoracoscopic native lung pneumonectomy after single lung transplant: initial experience with 2 cases†.
Single lung transplants (SLTs) leave in place a diseased lung, a potential source of complications. Native lung pneumonectomy is occasionally indicated. We present 2 cases of native lung complications (NLCs) managed with video-assisted thoracoscopic surgery (VATS) pneumonectomy at our institution, a procedure never reported in this context before. Case 1 involves a 59-year old gentleman with refractory, invasive pulmonary aspergillosis of the native lung, 5 years after SLT for idiopathic pulmonary fibrosis. Case 2 involves a 66-year old gentleman with α-1 antitrypsin deficiency who developed severe haemoptysis and intraparenchymal haemorrhage in the native lung 12 years after SLT. A VATS pneumonectomy was performed in both cases because we believed it would facilitate wound healing and hasten recovery in immunosuppressed patients. Our short-term results align with this hypothesis. We conclude that VATS pneumonectomy is a feasible, adequate and safe procedure in this patient population; larger series are needed to draw definitive conclusions.
Division of Cardiothoracic Surgery, Section of Thoracic Surgery, University of Wisconsin Hospital and Clinics, Madison, WI, USA.
Wassim
W
Abi Jaoude
Department of Surgery, SUNY Downstate Medical Center, Brooklyn, NY, USA brian.tiu@downstate.edu.
Brian
B
Tiu
Division of Cardiothoracic Surgery, Section of Thoracic Surgery, William S. Middleton Memorial Veterans Hospital, Madison, WI, USA.
Nicole
N
Strieter
Division of Cardiothoracic Surgery, Section of Thoracic Surgery, University of Wisconsin Hospital and Clinics, Madison, WI, USA Division of Cardiothoracic Surgery, Section of Thoracic Surgery, William S. Middleton Memorial Veterans Hospital, Madison, WI, USA.
James D
JD
Maloney
D000368:Aged; D005240:Feasibility Studies; D006469:Hemoptysis / Q000209:etiology / Q000601:surgery; D006801:Humans; D016040:Lung Transplantation / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000379:methods*; D055732:Pulmonary Aspergillosis / Q000000981:diagnostic imaging / Q000601:surgery; D011658:Pulmonary Fibrosis / Q000601:surgery; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed; D019896:alpha 1-Antitrypsin Deficiency / Q000601:surgery
Experimental thoracic surgery; Lung—other