Robotic left upper lobectomy after immunotherapy with suture reconstruction and reinforcement of the left upper lobe bronchus

ASVIDE ◽  
2021 ◽  
Vol 8 ◽  
pp. 215-215
Author(s):  
Prabhu Sasankan ◽  
Jonathan Hyde ◽  
Simeng Wang ◽  
Travis C. Geraci ◽  
Robert J. Cerfolio
2020 ◽  
pp. 1-2
Author(s):  
James Elliott ◽  
Anand Iyer ◽  
James Elliott

Patients undergoing Left Upper Lobectomy (LUL) appear to be at risk of a unique post-operative complication that is not well-documented: Pulmonary Vein (PV) stump thrombosis +/- systemic arterial embolisation [1-3]. We describe the details of a rare case from our institution, present a review of this subject from the limited literature available, and suggest potential strategies to anticipate, detect and manage this entity. A 70 year old female patient underwent left upper lobectomy and mediastinal lymph node sampling via repeat left thoracotomy. The procedure was unremarkable apart from some adhesions. She progressed well post-operatively on the ward. On post-operative day 2 the patient developed sudden-onset left leg pain and paraesthesia and CT-Angiography confirmed the diagnosis of left common femoral artery embolus and left superior PV stump thrombosis. The patient returned to theatre for femoral embolectomy, continued systemic anticoagulation, and made an excellent recovery thereafter. The aetiology of this complication has been documented in some case reports, but it is not explored further in trials or thoracic surgery texts [2-3]. One cohort study involving CT-angiography after lobectomy surgeries found that left upper lobectomy was unique as a risk factor for PV stump thrombosis1. It may be related to the relatively longer LSPV stump and stasis of blood in the stump [4].


2012 ◽  
Vol 143 (1) ◽  
pp. e3-e5 ◽  
Author(s):  
Kazuto Ohtaka ◽  
Yasuhiro Hida ◽  
Kichizo Kaga ◽  
Yasuaki Iimura ◽  
Nobuyuki Shiina ◽  
...  

1983 ◽  
Vol 92 (4) ◽  
pp. 387-390 ◽  
Author(s):  
Norman T. Berlinger ◽  
John Foker ◽  
Charles Long ◽  
Russell V. Lucas

Children with acyanotic congenital heart disease frequently develop respiratory difficulties such as atelectasis, pneumonia, or infantile lobar emphysema. In some cases, the cause of the respiratory difficulty is compression of the tracheobronchial tree by hypertensive dilated pulmonary arteries, since this type of heart disease frequently demonstrates large left-to-right intracardiac shunts. Sites of predilection for compression include the left main bronchus, the left upper lobe bronchus, the junction of the right bronchus intermedius and right middle lobe bronchus, and the left side of the distal trachea. Cardiac anomalies which predispose to this type of compression include ventricular septal defect, patent ductus arteriosus, interruption of the aortic arch, and tetralogy of Fallot. Pulmonary arteriopexy may relieve the tracheobronchial compression.


1959 ◽  
Vol 14 (5) ◽  
pp. 753-759 ◽  
Author(s):  
J. B. West ◽  
P. Hugh-Jones

Patterns of gas flow in the upper bronchial tree have been studied by observing the flow of dye and different gases through a lung cast, and by measurements made on open-chested dogs and on human beings at bronchoscopy. Flow is completely laminar throughout the bronchial tree at low expiratory flow rates (up to 10 l/min.) and completely turbulent, proximal to the segmental bronchi, at high flow rates (80 l/min.). Both at low and high expiratory flow rates, gas from segmental bronchi was not uniformly mixed in the lobar or main bronchi which they supplied. The composition of a catheter sample in these airways would therefore not be representative of the alveolar gas in the corresponding lobe or lung unless the alveolar gas in all areas distal to the sampling tube was homogeneous. Penetration of the left upper lobe bronchus by gas from the lower lobe was demonstrated in the model and a normal subject at bronchoscopy. Submitted on September 3, 1958


2020 ◽  
Vol 81 (6) ◽  
pp. 1085-1089
Author(s):  
Kyo HIRAYAMA ◽  
Masahiro MATSUNO ◽  
Nobuo TSUNOOKA ◽  
Mareyuki ENDO ◽  
Jyunichi AKAHIRA
Keyword(s):  

Haigan ◽  
2014 ◽  
Vol 54 (1) ◽  
pp. 6-11 ◽  
Author(s):  
Hirohisa Kato ◽  
Hiroyuki Oizumi ◽  
Takashi Inoue ◽  
Hikaru Watarai

2020 ◽  
Author(s):  
Henry Knipe ◽  
Craig Hacking
Keyword(s):  

Author(s):  
Francisco Alves De Sousa ◽  
Ana Costa Silva ◽  
Ana Nóbrega Pinto ◽  
Cecília Almeida E. Sousa

<p>Foreign body sensation is a common complaint in the otorhinolaryngology emergency. Careful examination of the patient’s pharynx is mandatory, but sometimes the object is not visualized. In such scenario, it may be important to explore signs and symptoms indicating lower aerodigestive impaction. This work describes the case of a 73-year-old woman without relevant comorbidities attending to emergency care. She complained of a foreign body sensation on the right side of the throat after ingesting a meal, which motivated referral to otorhinolaryngology. Flexible transnasal nasopharyngoscopy was unremarkable and no foreign bodies were found. Auscultation was performed revealing low-pitch expiratory wheezing on her right hemithorax. The suspicion of bronchial foreign body was then raised, which was ultimately confirmed by imaging and bronchoscopy, showing an impacted pea on the right lower lobe bronchus. The stethoscope was hence determinant for detecting aspiration, by revealing consistent alterations. Its usage should be encouraged in similar scenarios, highlighting the role of this classic but sometimes forgotten tool. Importantly, higher neck/throat sensations should not exclude the possibility of a lower airway foreign body.</p>


2021 ◽  
Vol 35 (7) ◽  
pp. 763-767
Author(s):  
Kazuharu Watanabe ◽  
Takafusa Yoshioka ◽  
Masaki Anraku
Keyword(s):  

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