Middle lobe torsion after right upper and lower lobectomy:repositioning of lobar torsion using a3-cm uniportal video-assisted thoracoscopic surgery

摘要

We aimed to describe a method for repositioning of right middle lobar torsion by using a3-cm uniportalvideo-assisted thoracoscopic surgery(VATS)approach.Middle lobe torsion occurred after right upper andlower lobectomy in a74-year-old man.Immediate re-exploratory thoracotomy using the3-cm uniportalVATS approach was performed.The torsion was corrected,and the lobe was anchored to the anterior chestwall with Prolene stitches.The patient recovered well postoperatively with daily improvements in chestradiographic findings.Follow-up examination was performed using fiberbronchoscopy,which revealed anunobstructed right middle lobe bronchus and sticky yellow sputum.Follow-up chest computed tomographywas performed3months after the primary surgery and revealed increased expansion of the right middlelobe.We repositioned the right middle lobe successfully by using the3-cm uniportal VATS approach,butmore cases are needed to confirm the feasibility of the approach.Lobectomy remains the primary treatmentoption for such cases.