[Postpneumonectomy syndrome in adults: description and therapeutic propositions apropos of 8 cases].

BACKGROUND

Adult post-pneumonectomy syndrome can be defined as an extrinsic compression of the main bronchus or a lobe bronchus on the aorta resulting from excessive mediastinal deviation after pneumonectomy.

PATIENTS: Eight cases in adults are reported. The delay to symptom onset was a mean 34 months. Three patients complained of increased dyspnea and 5 patients experienced a must more rapid course with adult respiratory distress syndrome in 1. Fibroscopy and chest CT confirmed the diagnosis of extrinsic compression of the main bronchus or a lobe bronchus.

RESULTS

In the first 2 patients, endoscopic treatment with an endobronchial prosthesis was unsuccessful. The mediastinum was recentered in the following patients using an inflatable prosthesis positioned in the pneumonectomy cavity. Clinical improvement was achieved in all patients. Fibroscopy and chest CT confirmed the reduction in bronchial compression.

DISCUSSION: Early diagnosis and mediastinal recentering are required for good outcome. Surveillance after pneumonectomy should include a search for mediastinal deviation and its consequences, particularly concerning the permeability of the remaining bronchi.