Skip to main content
SpringerLink
Log in

Evaluation of chest computed tomography in patients after pneumonectomy to predict contralateral pneumothorax

  • Original Article
  • Published:
General Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Purpose

Contralateral pneumothorax is a severe complication after pneumonectomy. We evaluated the mediastinal shift and the residual lung in patients who had undergone pneumonectomy to predict the incidence of contralateral pneumothorax.

Methods

We evaluated 21 cases of pneumonectomy performed from 1996 to 2006. For this study, we excluded patients with recurrent neoplasm, empyema, or hemothorax. We reviewed the computed tomography (CT) results of 13 patients who had undergone pneumonectomy to compare the bullae in the residual lungs, carina shifts, and herniation of the residual lungs before and after pneumonectomy. When evaluating the degree of herniation 4–6 cm below the carina, the anterior and posterior pulmonary hernias were classified as grade A, B, or C. We also investigated the preoperative respiratory function in all 13 patients. Results. Two patients suffered contralateral pneumothorax after left pneumonectomy. Both patients who suffered contralateral pneumothorax after pneumonectomy had bullae. The percentage forced expiratory volume in 1 s (FEV1.0%) was <70% in these two patients. Carina shifts and lung herniation were found to be greater after left pneumonectomy than after right pneumonectomy.

Conclusion

The bullae in the lung and obstructive pulmonary disease are associated not only with spontaneous pneumothorax but also with contralateral pneumothorax after pneumonectomy. Lung herniation and mediastinal shift are greater after left pneumonectomy than after right pneumonectomy, which may be related to contralateral pneumothorax after pneumonectomy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Harman H, Fergus S, Cole FH. Pneumonectomy: review of 351 cases. Ann Surg 1976;183:719–722.

    Google Scholar 

  2. Blalock JB. Contralateral pneumothorax after pneumonectomy for carcinoma. Dis Chest 1960;37:371–377.

    PubMed  CAS  Google Scholar 

  3. Arai T, Kinoshita G, Murakami H. Spontaneous pneumothorax on the contralateral side after pneumonectomy for pulmonary tuberculosis. Kyobu Geka 1960;18:883–892.

    Google Scholar 

  4. Hirata T, Matumura M, Takase H, Hirai Y. Late contralateral pneumothorax after pneumonectomy. Kyobu Rinsho 1970;14:808–812.

    Google Scholar 

  5. Suzuki K, Horicuchi T, Sakamoto R, Nagasima Y, Moriyama R. Two cases of contralateral pneumothorax after resection for lung cancer. Kyoubu Geka 1987;35:117–121

    Google Scholar 

  6. Harpole DH Jr, Liptay MJ, DeCamp MM Jr, Mentzer SJ, Swanson SJ, Sugarbaker DJ. Prospective analysis of pneumonectomy: risk factors for major morbidity and cardiac dysrhythmias. Ann Thorac Surg 1996;61:977–982.

    Article  PubMed  CAS  Google Scholar 

  7. Inui K, Reshad K, Takahashi Y, Yokomise H, Yagi K, Mizuno H, et al. Contralateral pneumothorax after lung surgery. Jpn J Chest Surg 1993;7:776–781.

    Article  Google Scholar 

  8. Kadokura M, Yamamoto S, Kataoka D, Nonaka M, Moriyasu Y, Tanio N, et al. Contralateral pneumothorax after lung resection. J Jpn Assn Thorac Surg 1997;45:1547–1551.

    CAS  Google Scholar 

  9. Kopec SE, Irwin RS, Umali-Torres CB, Balikian JP, Conlan AA. The postpneumonectomy state. Chest 1998;114:1158–1184.

    Article  PubMed  CAS  Google Scholar 

  10. Biondetti PR, Fiore D, Sartori F, Cologranto A, Ravasini R, Romani S. Evaluation of post-pneumonectomy space by computed tomography. J Comput Assist Tomogr 1982;6:238–242.

    Article  PubMed  CAS  Google Scholar 

  11. Goodman LR. Postoperative chest radiograph. II. Alterations after major intrathoracic surgery. AJR Am J Roentgenol 1980;134:803–813.

    PubMed  CAS  Google Scholar 

  12. Choe DH, Lee BH, Kim KH, Baek HJ, Park JH, Lee JC. Volume-expanding complications after pneumonectomy: comparison of CT findings. Clin Imaging 2006;30:173–176.

    Article  PubMed  Google Scholar 

  13. Christiansen KH, Morgan SW, Karich AF, Takaro T. Pleural space following pneumonectomy. Ann Thorac Surg 1965;122:298–304.

    Article  PubMed  CAS  Google Scholar 

  14. Light RW. Management of spontaneous pneumothorax. Am Rev Respir Dis 1993;148:245–248.

    PubMed  CAS  Google Scholar 

  15. Getz SB, Beasely WE. Spontaneous pneumothorax. Am J Surg 1983;145:823–827.

    Article  PubMed  Google Scholar 

  16. Smulders SA, Holverda S, Vonk-Noordegraaf A, Bosch CMVD, Post JC, Marcus JT, et al. Cardiac function and position more than 5 years after pneumonectomy. Ann Thorac Surg 2007;83:1986–1992.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Thoracic and Cardiovascular Surgery, Kansai Medical University Hospital, 2-3-1 Shinmachi, Hirakata, Osaka, 570-8506, Japan

    Tomohiro Maniwa, Yukihito Saito, Tomohito Saito, Hiroyuki Kaneda & Hiroji Imamura

Authors
  1. Tomohiro Maniwa
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yukihito Saito
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tomohito Saito
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hiroyuki Kaneda
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hiroji Imamura
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tomohiro Maniwa.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Maniwa, T., Saito, Y., Saito, T. et al. Evaluation of chest computed tomography in patients after pneumonectomy to predict contralateral pneumothorax. Gen Thorac Cardiovasc Surg 57, 28–32 (2009). https://doi.org/10.1007/s11748-008-0322-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11748-008-0322-z

Key words

Search

Navigation