Korean J Thorac Cardiovasc Surg.  2014 Oct;47(5):483-486. 10.5090/kjtcs.2014.47.5.483.

Reverse V-Shape Kinking of the Left Lower Lobar Bronchus after a Left Upper Lobectomy and Its Surgical Correction

• Kim MS
• Hwang Y
• Kim HS
• Park IK
• Kang CH
• Kim YT

• KMID: 2382195
• DOI: http://doi.org/10.5090/kjtcs.2014.47.5.483

Abstract

A 76-year-old male underwent a left upper lobectomy with wedge resection of the superior segment of the left lower lobe using video-assisted thoracoscopic surgery (VATS) for non-small-cell lung cancer of the left upper lobe. He presented with shortness of breath, fever, and leukocytosis. Chest radiography showed atelectasis at the remaining left lower lobe. Bronchoscopy revealed narrowing of the left lower bronchus with purulent secretion, and computed tomography showed downward kinking of the left lower lobar bronchus. He underwent exploratory VATS, and intraoperative findings showed an inferiorly kinked left lower lobar bronchus with upward displacement of the left lower lobe. After adhesiolysis, the kinked bronchus was straightened, and bronchopexy was performed to the pericardium to prevent the recurrence of bronchial kinking. Also, the inferior pulmonary ligament was reattached to prevent upward displacement. Postoperative follow-up bronchoscopy revealed no evidence of residual bronchial obstruction, and chest radiography showed no atelectasis thereafter.

Keyword

Airway obstruction; Video-assisted thoracic surgery (VATS); Complications of surgery

MeSH Terms

Aged
Airway Obstruction
Bronchi*
Bronchoscopy
Dyspnea
Fever
Follow-Up Studies
Humans
Leukocytosis
Ligaments
Lung Neoplasms
Male
Pericardium
Pulmonary Atelectasis
Radiography
Recurrence
Thoracic Surgery, Video-Assisted
Thorax