title: Contralateral tension pneumothorax during video-assisted thorascoscopic surgery for lung cancer: a case report.
abstract: Contralateral tension pneumothorax during one-lung ventilation is a rare but catastrophic surgical complication. A 72-year-old Japanese male with lung cancer underwent right upper lobectomy with video-assisted thoracoscopic surgery. Despite use of various methods for maintaining oxygenation during one-lung ventilation, percutaneous oxygen saturation was unstable from the start of surgery and suddenly decreased with a drop in blood pressure. An intraoperative chest X-ray revealed a tension pneumothorax of the dependent lung. Insertion of a chest drain saved the patient's life. This case suggests that a contralateral tension pneumothorax should be considered as a possible cause when adequate oxygenation cannot be maintained during one-lung ventilation.
authors.affiliation: Department of General Thoracic Surgery, Kanagawa Cardiovascular and Respiratory Center, 6-16-1 Tomiokahigashi, Kanazawa-ku, Yokohama, 236-8651, Japan.
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Arai
authors.affiliation: Department of General Thoracic Surgery, Kanagawa Cardiovascular and Respiratory Center, 6-16-1 Tomiokahigashi, Kanazawa-ku, Yokohama, 236-8651, Japan.
authors.forename: Michihiko
authors.initials: M
authors.lastname: Tajiri
authors.affiliation: Department of Anesthesiology, Yokohoma City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan.
authors.forename: Keigo
authors.initials: K
authors.lastname: Ebuchi
authors.affiliation: Department of General Thoracic Surgery, Kanagawa Cardiovascular and Respiratory Center, 6-16-1 Tomiokahigashi, Kanazawa-ku, Yokohama, 236-8651, Japan.
authors.forename: Kohei
authors.initials: K
authors.lastname: Ando
authors.affiliation: Department of Pathology, Yokohoma City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Okudela
authors.affiliation: Department of Anesthesiology, Kanagawa Cardiovascular and Respiratory Center, 6-16-1 Tomiokahigashi, Kanazawa-ku, Yokohama, 236-8651, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Gamo
authors.affiliation: Departoment of Surgery, Yokohoma City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan.
authors.forename: Munetaka
authors.initials: M
authors.lastname: Masuda
mesh_terms: D000368:Aged; D006801:Humans; D007431:Intraoperative Complications; D008175:Lung Neoplasms / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D016343:Monitoring, Intraoperative / Q000009:adverse effects*; D011013:Pneumonectomy / Q000009:adverse effects*; D011030:Pneumothorax / Q000175:diagnosis / Q000209:etiology*; D013902:Radiography, Thoracic; D012075:Remission, Spontaneous; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed
keywords: contralateral; one-lung ventilation (OLV); pneumothorax; video-assisted thoracoscopic surgery (VATS)