Single lung resection: The limits of the possible. Clinical report

Highlights • Removal of the non-functioning part of the lung eliminates the air/vascular shunt. • it may cause an improvement of cardiorespiratory function. • single lung resection is possible with the functional futility of the removed part.
Introduction Single lung resection remains a challenge due to the preservation of the respiratory reserve. This report presents that case of a female patient with bilateral fibrotic-cavitary pulmonary tuberculosis complicated with empyema on the right lung. Only 3.5 lung segments were left after a multistage surgery. Presentation of case The first stage included draining of empyema and transsternal transmediastinal right main bronchus occlusion. Then, upper lobectomy with partial S6 resection of the left lung, followed by pleuropneumonectomy was performed. At a follow-up of two years and 10 months, patient’s condition was good. Discussion Although single lung surgery has been possible over half a century ago, it remains a high-risk intervention. Conclusion With the removal of the non-functioning parenchyma and elimination of the air/vascular shunt, single lung resection volume exceeding lobectomy is possible, which may improve cardiorespiratory function.