2024 Asia Conference on Lung Cancer (ACLC) - Poster & ePosters-EP02.27

EP02.27 - Xiaolong Wang

Pdf Summary

This case study details the treatment and recovery of a 64-year-old woman with multiple pulmonary nodules, primarily in the right upper lobe. She underwent thoracoscopic right upper lobe resection, and intraoperative pathology confirmed adenocarcinoma. A systematic lymph node dissection was performed, and the pulmonary ligament was loosened while the right middle lobe was sutured to the lower lobe.<br /><br />Post-operation, the patient was diagnosed with right middle lobe atelectasis on postoperative day 2 (POD2), revealed by a chest CT scan. This scan showed a collapsed middle lobe with no signs of torsion, which ruled out lung torsion. The patient did not exhibit symptoms like dyspnea or fever, and her oxygen levels remained normal. She refused further interventions such as fiberoptic bronchoscopy lavage or non-invasive ventilation therapy. Attempts to address the atelectasis through nebulization and chest physiotherapy were ineffective by POD7. However, because her vital signs were stable, she was discharged with instructions for close monitoring.<br /><br />Throughout the first and third months post-surgery, the atelectasis remained unchanged. It was initially believed this could lead to permanent collapse. However, in the fourth month post-surgery, the patient experienced a sudden intense episode of coughing. This was followed by a CT scan showing the middle lobe had expanded, though it was smaller than its original preoperative size.<br /><br />Remarkably, the patient maintained good health through a five-year follow-up period, indicating a successful long-term recovery despite the post-operative complications and the atelectasis resolving unexpectedly after the coughing episode.

Keywords

pulmonary nodules

thoracoscopic resection

adenocarcinoma

lymph node dissection

right middle lobe atelectasis

postoperative complications

chest CT scan

nebulization

chest physiotherapy

long-term recovery