Extended double sleeve lobectomy combined with thoracic wall resection to treat a huge lung cancer

A 58-year-old man came to our hospital with numbness of the left arm, fatigue, and fever. A huge solid mass with necrotic changes located in the left upper lobe was noted on the computed tomography scan. The tumor directly invaded the extrathoracic wall, the left main pulmonary artery, and the superior segment of the lower lobe. To avoid pneumonectomy, a combination of an extended double sleeve lobectomy and thoracic wall resection was performed. The postoperative course was uneventful. The patient has survived without any recurrence for 6 months postoperatively.

The Use of Polypropylene Mesh in the Reconstruction Techniques of the Thoracic Wall After Resections of the Thoracic Wall

The thoracic wall resections for tumoral affections are laborious surgical interventions characterized by a high mortality and mobility. In order to create this paper we created a observational retrospective study in which we included 21 patients that have underwent parietal thoracic resections for tumoral affections. In all the patients we practiced the reconstruction of the thoracic wall using polypropylene mesh. The main postoperative complications were: seromas (14.28% of the cases), hematomas (9.52% of the cases), wound infection (4.76% of the cases), pneumonia (23.8% of the cases), respiratory failure (23.8% of the cases), paradoxical movement of the thoracic wall (52.38% of the cases). No deceases were recorded. In conclusion, the use of polypropylene mesh in the reconstructive techniques of the thoracic wall after thoracic wall resection represents a viable method, with good respiratory functional results.

Recurrent Intrathoracic Locking of the Scapula after Lung Cancer Resection and Combined Rib Resection

We report a case of recurrent locking of the scapula in the thorax after combined lobectomy and thoracic wall resection for advanced lung cancer. The patient was a 52-year-old man with advanced spindle cell carcinoma in his right lung. He had undergone right lung lobectomy and thoracic wall excision (Th1–5). Intrathoracic repair had not been performed to address the defect in the thoracic wall. Two months after the operation he experienced sudden acute pain in the right shoulder. Three-dimensional computed tomography revealed locking of the scapula intrathoracically. The diagnosis was recurrent locking of the scapula in the thorax. He underwent conservative treatment. Because his symptoms were not alleviated and he continued to experience recurrent locking, we performed partial resection of the inferior part of the scapula. Although scapular locking diminished after this procedure, there were still some pain and “catching” between the scapula and the thoracic wall (T6) when he undertook certain movements. No further surgery could be performed, however, because the cancer from the primary lesion had recurred near the previously operated thoracic wall. A procedure for recurrent intrathoracic locking of the scapula was not successful in this case.