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Abscess of residual lobe after pulmonary resection for lung cancer

Tommaso Ligabue1, Luca Voltolini, Claudia Ghiribelli

  • 1Thoracic Surgery Unit, University Hospital of Siena, Viale Bracci 14, 53100 Siena, Italy. tligabue@hotmail.com

Asian Cardiovascular & Thoracic Annals
|April 3, 2008
PubMed

Insights

Residual lobar abscess is a rare, lethal complication after lung lobectomy. Early diagnosis via CT scans and surgical resection are recommended for suspected cases presenting with fever and consolidation.

Area of Science:

  • Thoracic Surgery
  • Pulmonary Medicine
  • Surgical Complications

Background:

  • Post-lobectomy abscess of the residual lung lobe is a rare but serious complication.
  • Non-small-cell lung cancer surgery involves risks, including residual lobe complications.

Purpose of the Study:

  • To investigate the incidence, diagnosis, and management of residual lobar abscess following pulmonary lobectomy.
  • To highlight key diagnostic indicators and recommended treatments for this rare complication.

Main Methods:

  • Retrospective review of 1,460 patients undergoing pulmonary lobectomy for non-small-cell lung cancer (1975-2006).
  • Analysis of diagnostic methods including chest radiography, flexible bronchoscopy, and computed tomography (CT).
  • Evaluation of surgical interventions and post-operative outcomes.

Main Results:

  • Five cases (0.3%) of residual lobar abscess were identified (4 bilobectomies, 1 lobectomy).
  • Diagnostic findings included consolidation, bronchial occlusion, and CT-identified abscess foci.
  • Surgical treatment involved completion pneumonectomy (3 patients) or lobectomy (1 patient), with one instance of sepsis.

Conclusions:

  • Residual lobar abscess should be suspected in patients with persistent fever, leukocytosis, and consolidation post-lobectomy.
  • Computed tomography is crucial for early and accurate diagnosis.
  • Surgical resection of the affected lobe is the recommended treatment approach.

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