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M. Inoue
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P3.04 - Poster Session with Presenters Present (ID 474)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Surgery
- Presentations: 1
- Moderators:
- Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)
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P3.04-042 - 2 Cases of Fast-Growing Emphysematous Bullae Following Lobectomy for Lung Cancer (ID 5691)
14:30 - 14:30 | Author(s): M. Inoue
- Abstract
Background:
Emphysematous bullae usually grow gradually. We experienced 2 of those which came out and expanded in a few days after lobectomy for lung cancer.
Methods:
The first case: A 78-year-old man underwent right upper lobectomy for squamous cell carcinoma (cT1bN1M0). Air leak stopped in the morning of the 4th postoperative day (POD). Sever air leak recurred when he coughed during lunch on that day. Computed Tomography (CT) revealed a large bulla on the right S6 that we had never seen on his any preoperative imaging examinations neither in operation. The second case: A 66-year-old man had past medical history of infectious giant bulla on the left lung which was treated by surgery 10 years ago. This time, he had left upper lobectomy under diagnosis of adenocarcinoma (cT2aN0M0). Postoperative air leak almost stopped in the afternoon on the 3rd POD. In the evening on the same day, sever air leak relapsed after his coughing hard. CT revealed a large bulla on the left S6 that was recognized for the first time. Figure 1
Results:
In both cases we performed operation and found massive air leak coming out from holes on the bullae. We removed the bullae and stitched up leak points. We succeeded in reducing air leak at last. Their drains were removed in 2 weeks. Both of them are in good condition now.
Conclusion:
There are several similarities between these 2 cases. They had pulmonary emphysema but no bullae detected on preoperative CT. Recurrence of air leak after coughing triggered discovery of new occurring bullae, while postoperative air leak was being improved. It can be said that emphysema, improvement of air leak and coughing have something to do with onset of fast-growing bullae. We surgeons may have to keep in our mind the possibility of such occurrence, when we operate on similar patients as them.
