Casanova Viúdez J, Mariñán Gorospe M, Rumbero Sánchez J C
Servicio de Cirugía Torácica, Hospital de Cruces, Baracaldo, Vizcaya, Spain.
Arch Bronconeumol. 2002 Jan;38(1):51-4. doi: 10.1016/s0300-2896(02)75147-8.
Postpneumonectomy syndrome is a rare complication of pneumonectomy that develops as a result of excessive displacement of mediastinal structures into the empty cavity. We report the case of a 72-year-old man who developed dysphagia and progressive weakness, along with signs of hypotension due to low cardiac output, following removal of the left lung for lung cancer. Intubation and transfer to the intensive care unit was necessary. When such causes as pulmonary embolism, pneumonia and COPD exacerbation had been ruled out, postpneumonectomy syndrome was diagnosed. Two tissue expansion prostheses (100 mL and 400 mL) were implanted surgically to keep the mediastinum in position and reverse symptoms immediately. We conclude that postpneumonectomy syndrome after left pneumonectomy is a rare complication that may be more frequent than the literature suggests, given that signs may be masked by a diagnosis of cardiogenic shock that leads to death. Surgical repair is simple, reversing symptoms immediately.
肺切除术后综合征是肺切除术后一种罕见的并发症，由于纵隔结构过度移位至空胸腔而发生。我们报告一例72岁男性病例，该患者因肺癌切除左肺后出现吞咽困难和进行性肌无力，同时伴有因心输出量低导致的低血压体征。需要进行插管并转入重症监护病房。在排除肺栓塞、肺炎和慢性阻塞性肺疾病加重等病因后，诊断为肺切除术后综合征。通过手术植入两个组织扩张假体（100毫升和400毫升），以固定纵隔并立即缓解症状。我们得出结论，左肺切除术后的肺切除术后综合征是一种罕见的并发症，鉴于其症状可能被导致死亡的心源性休克诊断所掩盖，其实际发生率可能比文献报道的更高。手术修复简单，可立即缓解症状。
