Wasserman K, Jamplis R W, Lash H, Brown H V, Cleary M G, Lafair J
Chest. 1979 Jan;75(1):78-81. doi: 10.1378/chest.75.1.78.
A post-right pneumonectomy syndrome is described which manifests symptoms of exertional dyspnea and inspiratory stridor on rapid inspiration. These symptoms were associated with marked rightward and posterior deviation of the trachea, over-distention of the left lung with its herniation into the right side of the chest and kinking of the left lower lobe bronchus. At the time of surgery, the tracheal deviation, lung herniation and the kink in the left lower lobe bronchus were immediately corrected by releasing the adhesions between the malpositioned structures and the right chest wall. To maintain the corrected positions, Silastic implants totalling a volume of 990 ml were placed into the space created in the right chest. Following surgery, exertional dyspnea was present with only extraordinary activity, and inspiratory stridor was eliminated. The patient remains asymptomatic three years following surgical correction, and is able to carry on a normal and productive life. We conclude that a syndrome associated with marked exertional dyspnea and inspiratory stridor might develop in situations of marked tracheal shift and overdistention of the remaining lung following right pneumonectomy.
本文描述了一种右肺切除术后综合征，其表现为运动性呼吸困难以及快速吸气时的吸气性喘鸣症状。这些症状与气管明显向右后方移位、左肺过度膨胀并疝入右侧胸腔以及左下叶支气管扭结有关。手术时，通过松解错位结构与右胸壁之间的粘连，立即纠正了气管移位、肺疝以及左下叶支气管的扭结。为保持纠正后的位置，将总体积为990毫升的硅橡胶植入物置入右胸形成的空间内。术后，仅在进行剧烈活动时出现运动性呼吸困难，吸气性喘鸣消失。手术矫正三年后患者仍无症状，能够正常生活并从事有意义的工作。我们得出结论，右肺切除术后，在气管明显移位和余肺过度膨胀的情况下，可能会出现与明显运动性呼吸困难和吸气性喘鸣相关的综合征。
