Revival of impaired lung perfusion after sleeve lobectomy

Abstract

Sleeve resection, a mainstay for centrally-located lung cancer, is a challenging procedure when the preserved lung is impaired. We herein reported a 61-year-old male who underwent right upper sleeve lobectomy for squamous cell carcinoma located at the orifice of the upper bronchus. The tumor invaded the main bronchus. A lung perfusion scan showed severe impairment, while the right middle and lower lobes were well expanded. Not only the spirogram, but also the lung perfusion in the residual lung, had markedly recovered at 2 months after the right upper extended sleeve lobectomy. The patient is currently living his normal daily life. Residual lung perfusion can be revived, even if it is impaired preoperatively.

Keywords: Centrally-located lung cancer; lung perfusion; sleeve resection.

Figure 1

Chest computed tomographic image showing a 30 mm × 30 mm × 33 mm mass with an intraluminal growth at the right upper bronchus, invading into the main bronchus (A). Atelectasis of the right upper lobe is seen, while the middle and lower lobes are well expanded (B).

Figure 2

Lung perfusion scans before (A) and after (B) surgery. The perfusion of the right lung is restricted to 7.3% (A). The perfusion has recovered up to 20.7% at 2 months after the sleeve lobectomy (B).