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Video-Assisted Thoracoscopic Conservative Repair of Postoperative Lobar Torsion  Mitsuaki Sakai, MD, PhD, Kou Kurimori, MD, Yusuke Saeki, MD, Shinsuke.

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Presentation on theme: "Video-Assisted Thoracoscopic Conservative Repair of Postoperative Lobar Torsion  Mitsuaki Sakai, MD, PhD, Kou Kurimori, MD, Yusuke Saeki, MD, Shinsuke."— Presentation transcript:

1 Video-Assisted Thoracoscopic Conservative Repair of Postoperative Lobar Torsion 
Mitsuaki Sakai, MD, PhD, Kou Kurimori, MD, Yusuke Saeki, MD, Shinsuke Kitazawa, MD, Keisuke Kobayashi, MD, Kesato Iguchi, MD, PhD, Yukio Sato, MD, PhD  The Annals of Thoracic Surgery  Volume 98, Issue 5, Pages e119-e121 (November 2014) DOI: /j.athoracsur Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 (A) Computed tomography at the time of middle lobe torsion onset, which reveals the sharply shaped occlusion of the pulmonary vein and enhancement of the peripheral pulmonary artery (white asterisk). (B) Day 7 after repairing the torsion. The middle lobe is partially expanded, but a pulmonary vein thrombus is formed (white arrowhead). (C): Six months after the repair, the middle lobe is fully expanded, and the pulmonary vein thrombus has disappeared. (LA = left atrium; PA = pulmonary artery; RML = right middle lobe.) The Annals of Thoracic Surgery  , e119-e121DOI: ( /j.athoracsur ) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 (A): The right middle lobe was twisted approximately 150 degrees counterclockwise (white arrowhead). (B) Massive serous bloody sputum was secreted into the airway immediately after detorsion. The sputum disappeared spontaneously after 1 h of continuous suction; thereafter, the orifice of the middle lobe bronchus appeared. (C) The surface color, elasticity, and compliance of the middle lobe improved after detorsion. (D) We attached the middle lobe to the lower lobe by over-and-over suture to avoid re-torsion. (RLL = right lower lobe; RML = right middle lobe.) The Annals of Thoracic Surgery  , e119-e121DOI: ( /j.athoracsur ) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

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