Farkas Emily A, Detterbeck Frank C
Division of Thoracic Surgery, Yale University School of Medicine, 330 Cedar Street, New Haven, CT 06520-8062, USA.
Thorac Surg Clin. 2006 Aug;16(3):243-51. doi: 10.1016/j.thorsurg.2006.05.013.
Airway complications following pulmonary resection remain a challenging problem. A high degree of clinical suspicion, contrasted CT imaging, and early reoperation are crucial in preserving viable lung parenchyma following the anatomic compromise of lobar torsion. Likewise, early recognition and expeditious drainage of the pleural space in the setting of bronchial dehiscence may help prevent the aspiration pneumonia and consequent respiratory failure that is the leading cause of death in this patient population; A variety of interventions to manage stump dehiscence are possible, but successful management still remains difficult and requires an individualized approach. Attention to technical details and avoidance of extensive dissection and tension should yield acceptably low rates of postoperative stenosis following bronchoplastic resection. These common themes of precise surgical technique, vigilance in the perioperative period, and classic sound judgment in addressing problems effectively and expeditiously remain pivotal in the minimization of sequelae from morbid airway complications.
