Procedure

Postpneumonectomy syndrome

^a Division of Thoracic Surgery, Hôpital Maisonneuve-Rosemont (University of Montreal), 5415 boulevard de l'Assomption, Montréal, Que H1T 2M4, Canada
^b Department of Anesthesia, Hôpital Laval, Centre universitaire de cardiologie et de pneumologie (Laval University), Ste-Foy, Que, Canada
^c Division of Thoracic Surgery, Hôpital Laval, Centre universitaire de cardiologie et de pneumologie (Laval University), Ste-Foy, Que, Canada

^* Corresponding author: Tel.: +1-514-252 3822 ext. 7703; fax: +1-514-252 3894. george.rakovich{at}umontreal.ca

Postpneumonectomy syndrome is a rare postoperative complication whereby mediastinal shifting toward the pneumonectomy space results in bronchial compression between the pulmonary artery, aorta, and vertebral column. This syndrome is more common after right pneumonectomy; other risk factors include young age and female sex. Imaging studies consistently reveal massive mediastinal shifting and document airway compromise. Bronchoscopy and flow-volume loops are helpful in confirming the diagnosis. Other causes of dyspnea, including cancer recurrence, should be excluded. Definitive treatment involves surgical repositioning of the mediastinum in the midline, as well as insertion of a saline-filled silicone prosthesis into the pneumonectomy space in order to prevent recurrence.

Key Words: Airway obstruction • Complications • Pneumonectomy