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Vol. 45. Issue 12.
Pages 617-619 (December 2009)
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Vol. 45. Issue 12.
Pages 617-619 (December 2009)
Case report
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Left Postpneumonectomy Syndrome: Early Endoscopic Treatment
Síndrome posneumonectomía izquierda. Tratamiento endoscópico precoz
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Carlos A. Romboláa,
Corresponding author
carrombola@hotmail.com

Corresponding author.
, Pablo León Atancea, Antonio Francisco Honguero Martíneza, Juan Luis Rueda Martínezb, Ana Núñez Aresc, Manuel Vizcaya Sánchezc
a Servicio de Cirugía Torácica, Hospital General Universitario, Albacete, Spain
b Servicio de Cirugía General, Hospital General Universitario, Albacete, Spain
c Servicio de Neumología, Hospital General Universitario, Albacete, Spain
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Abstract

Postpneumonectomy syndrome is characterized by postoperative bronchial obstruction caused by mediastinal shift. The syndrome is well documented in the medical literature as a late complication of right pneumonectomy; however, it rarely occurs following resection of the left lung, and only 10 cases have been published. The pathophysiology, clinical manifestations, prognosis, and treatment are similar for both sides of the lung.

We present the case of an adult patient who underwent left pneumonectomy and developed postpneumonectomy syndrome 15 months later. Stenosis of the intermediate bronchus occurred between the vertebral body and the right pulmonary artery. Endoscopic treatment with a self-expanding metal wallstent was successful, and complete remission was observed over the 6 months of follow-up.

Keywords:
Postpneumonectomy syndrome
Postpneumonectomy complications
Endoscopic treatment
Resumen

Se entiende por síndrome posneumonectomía la obstrucción bronquial postoperatoria, causada por un desplazamiento exagerado del mediastino. Este síndrome está bien documentado en la literatura médica como complicación tardía de una neumonectomía derecha, pero su producción tras una resección del pulmón izquierdo es excepcional, pues apenas se ha publicado una decena de casos. La fisiopatología, las manifestaciones clínicas, el pronóstico y el tratamiento son similares para ambos lados.

Presentamos el caso de un paciente adulto a quien se practicó una neumonectomía izquierda y que desarrolló un síndrome posneumonectomía a los 15 meses del postoperatorio. La estenosis del bronquio intermediario se produjo entre el cuerpo vertebral y la arteria pulmonar derecha. Se efectuó eficazmente tratamiento endoscópico con una prótesis metálica autoexpandible, con lo cual se observó la remisión completa de los síntomas durante los 6 meses de seguimiento.

Palabras clave:
Síndrome posneumonectomía
Complicaciones posneumonectomía
Tratamiento endoscópico
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Copyright © 2009. Sociedad Española de Neumología y Cirugía Torácica
Archivos de Bronconeumología
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