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  P3.CR - Case Reports (Not CME Accredited Session) (ID 984)

  • Event: WCLC 2018
  • Type: Poster Viewing in the Exhibit Hall
  • Track:
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall

  • 27849

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    P3.CR-30 - Pleural Diseases on Single Lung After Pneumonectomy for Cancer   (ID 11267)

    12:00 - 13:30  |  Presenting Author(s): Veronica Manolache
    • Abstract
    • Slides

    Background
    

    After pneumonectomy for cancer, the residual lung can be affected by pleural disorders, which usually produce severe respiratory distress and impose emergency treatment.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    Between 2000 and 2016 we identified 11 patients with previous pneumonectomy for cancer, who presented with pleural disease; 9 of them needed emergency treatment.

    4c3880bb027f159e801041b1021e88e8 Result
    

    There were 2 cases of pneumothorax: one developed in first postoperative day after left completion pneumonectomy with chest wall re-resection (for relapsed squamous cell carcinoma); the second pneumothorax developed after CT-guided needle biopsy of a left pulmonary nodule (single left lung after right pneumonectomy for cancer) – in both cases the pneumothorax needed emergency chest tube drainage.

    Also, there were 8 cases with liquid pleural effusions – 6 malignant, 1 tuberculous and 1 empyema. We performed 2 thoracoscopies and 6 chest drain insertions; in one case the patient with previous left pneumonectomy presented with right pleural and pericardial effusion, for which a pericardial percutaneous left parasternal drainage with ultrasound guidance, and a right pleurotomy, were performed. In another case a left tension loculated pleural effusion needed CT-guided percutaneous drainage. In 3 cases talc pleurodesis was performed.

    Finally, one patient with previous pneumonectomy presented with left pulmonary nodule and he was prepared for resection. At thoracotomy a pleural entrapment of the inferior lingular segment was found and a decortication was performed; no pulmonary nodule was found neither intraoperatory nor at postoperatory CT-scan.

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    The pleural disease developed on single surgical lung (pneumonectomy for cancer) may be malignant or benign, correlated or not with the primary malignancy which imposed previous pneumonectomy. In endemic areas for TB specific pleural effusions and pleural retraction may appear and surgical treatment is necessary. Special attention is needed for nodules on single lung proposed for CT-guided biopsy – the pneumothorax on single lung has indication for drainage.

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