Adult post-pneumonectomy syndrome: description and therapeutic propositions in 8 cases.

Background: Adult post-pneumonectomy syndrome can be defined as an extrinsi c compression of the main bronchus or a lobe bronchus on the aorta resultin g from excessive mediastinal deviation after pneumonectomy. Patients: Eight cases in adults are reported. The delay to symptom onset wa s a mean 34 months. Three patients complained of increased dyspnea and 5 pa tients experienced a must more rapid course with adult respiratory distress syndrome in 1. Fibroscopy and chest CT confirmed the diagnosis of extrinsi c compression of the main bronchus or a lobe bronchus. Results: in the first 2 patients, endoscopic treatment with an endobronchia l prosthesis was unsuccessful. The mediastinum was recentered in the follow ing patients using an inflatable prosthesis positoned in the pneumonectomy cavity. Clinical improvement was achieved in all patients. Fibroscopy and c hest CT confirmed the reduction in bronchial compression. Discussion: Early diagnosis and mediastinal recentering are required for go od outcome. Surveillance after pneumonectomy should include a search for me diastinal deviation and its consequences, particularly concerning the perme ability of the remaining bronchi.