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Right Upper-lower Bilobectomy for Double Primary Non-small Cell Lung Cancer

Kentaro Miura, Masayuki Toishi, Kazutoshi Hamanaka, Takayuki Shiina


Introduction: Right upper-lower bilobectomy is rarely performed for non-small cell lung cancer. The prevention of middle lobe torsion is an important aspect of this procedure.

Presentation of case: The patient was 68-year-old man. He had double primary Stage1B non-small cell lung cancer, and requiring right upper-lower bilobectomy. The residual middle lobe was rotated approximately 90° in spite of sutured to the diaphragm. This event leads to pooling of sputum and the subsequent development of bacterial pneumonia in the middle lobe. Moreover, acute respiratory distress syndrome developed in the left lung arising secondarily to bacterial pneumonia. The patient died on postoperative day 42 due to respiratory failure.

Conclusion: Fixation of the residual middle lobe is important during right upper-lower bilobectomy.


upper-lower bilobectomy; middle lobe torsion; acute respiratory distress syndrome

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