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Lobar torsion after pulmonary resection: presentation and outcome
D G Cable1, C Deschamps, M S Allen
1Division of General Thoracic Surgery, Mayo Clinic and Mayo Foundation, Rochester, Minn 55905, USA.
The Journal of Thoracic and Cardiovascular Surgery
|December 1, 2001
Summary
Postoperative lobar torsion is a rare complication after pulmonary resection. Early diagnosis is crucial to avoid further surgery and prolonged hospital stays.
Area of Science:
- Thoracic Surgery
- Pulmonary Medicine
- Surgical Complications
Background:
- Postoperative lobar torsion is a rare but serious complication following pulmonary resection.
- It presents a diagnostic challenge in the early postoperative period.
Purpose of the Study:
- To review the authors' experience with postoperative lobar torsion.
- To highlight the diagnostic difficulties and outcomes associated with this condition.
Main Methods:
- Retrospective review of 7887 pulmonary resections performed between 1972 and 1998.
- Identification of 7 patients (0.089%) who required reintervention for lobar torsion.
Main Results:
- Lobar torsion occurred in 7 patients after various pulmonary resections, with a median diagnosis time of 10 days postoperatively.
- Patients experienced symptoms including pulmonary infiltrates, volume loss, or opacification, with elevated white blood cell counts and fever.
- Reoperation involved completion pneumonectomy or lobectomy, leading to a median hospitalization of 24 days, with no postoperative deaths but significant complications.
Conclusions:
- Postoperative lobar torsion is a diagnostic dilemma requiring a high index of suspicion.
- Delayed diagnosis necessitates further pulmonary resection and extends hospitalization.
- Prompt recognition and intervention are essential for optimal patient outcomes.
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