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Residual middle lobectomy after right upper or lower lobectomy: indications and outcome

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Abstract

Objectives

Residual middle lobectomy after upper lobectomy and lower lobectomy differs in their indications and perioperative outcomes. Therefore, we aimed to evaluate the indications and perioperative outcomes of residual middle lobectomy after upper and lower lobectomy.

Methods

The data of 14 patients who underwent residual middle lobectomy after upper or lower lobectomy between January 1997 and December 2021 were extracted and analyzed.

Results

Overall, six patients underwent residual middle lobectomy after upper lobectomy. The indication was second primary lung cancer in five patients and local recurrence in the hilar lymph node between the middle and lower lobar bronchi in one patient. However, one patient was treated with the R2 operation. The remaining eight patients underwent residual middle lobectomy after lower lobectomy. The indication was second primary lung cancer and bronchopleural fistula or stenosis in two and six patients, respectively. No postoperative 90-day mortality was observed.

Conclusions

Residual middle lobectomy for second lung cancer after upper lobectomy is difficult because of severe hilar adhesions. Simultaneous resection of hilar structures or pulmonary artery and parenchyma might be an option. Residual middle lobectomy could be a treatment option for bronchopleural fistula or stenosis after lower lobectomy.

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Data availability

The data underlying this article are available in the article and in its online supplementary materials.

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Acknowledgements

We thank Editage (www.editage.jp) for the English language editing.

Funding

The research reported in this publication was not supported by any external funding or grant.

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Authors and Affiliations

  1. Department of Surgery II, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan

    Satoshi Takamori, Jun Suzuki, Hikaru Watanabe, Kaito Sato, Satoshi Shiono & Tetsuro Uchida

  2. Department of General Thoracic Surgery, Higashiyamato Hospital, 1-13-12 Nangai, Higashiyamato, Tokyo, 207-0014, Japan

    Satoshi Takamori & Hiroyuki Oizumi

Authors
  1. Satoshi Takamori
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  2. Hiroyuki Oizumi
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  3. Jun Suzuki
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  6. Satoshi Shiono
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Contributions

ST: conceptualization; data curation; formal analysis; methodology; writing—original draft. HO: conceptualization; project administration; supervision; writing—review & editing. JS: supervision; writing—review & editing. HW: supervision; writing—review & editing. KS: conceptualization. SS: supervision; writing—review & editing. TU: conceptualization.

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Correspondence to Satoshi Takamori.

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Takamori, S., Oizumi, H., Suzuki, J. et al. Residual middle lobectomy after right upper or lower lobectomy: indications and outcome. Gen Thorac Cardiovasc Surg 71, 525–533 (2023). https://doi.org/10.1007/s11748-023-01919-6

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  • DOI: https://doi.org/10.1007/s11748-023-01919-6

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