[Left postpneumonectomy syndrome: early endoscopic treatment]

Area of Science:

• Thoracic Surgery
• Pulmonology
• Medical Case Reports

Background:

• Postpneumonectomy syndrome (PPS) is a known complication after lung resection, typically following right pneumonectomy.
• It involves bronchial obstruction due to mediastinal shift, leading to respiratory compromise.
• PPS after left pneumonectomy is exceptionally rare, with limited published cases.

Observation:

• A patient who underwent left pneumonectomy developed PPS 15 months post-surgery.
• The patient presented with stenosis of the intermediate bronchus, compressed between the vertebral body and the right pulmonary artery.
• Clinical manifestations and pathophysiology were consistent with previously reported PPS cases.

Findings:

• Endoscopic evaluation confirmed intermediate bronchus stenosis.
• Treatment involved the successful placement of a self-expanding metal stent.
• The patient achieved complete remission of symptoms over a 6-month follow-up period.

Implications:

• This case demonstrates that PPS can occur after left pneumonectomy and shares similar characteristics with right-sided cases.
• Endoscopic stenting is an effective treatment modality for bronchial stenosis in PPS.
• Further research into the specific mechanisms and optimal management of left-sided PPS is warranted.