What the study found
The report describes two cases of right middle lobe torsion, a twisting of a lung lobe, after right upper lobectomy. In both cases, persistent postoperative atelectasis, or collapse of part of the lung, led to repeated bronchoscopy and contrast-enhanced computed tomography, which supported early diagnosis and timely surgery.
Why the authors say this matters
The authors conclude that middle lobe torsion is an uncommon but potentially life-threatening complication and that it should be considered when atelectasis persists despite preserved oxygenation. They also suggest that systematic imaging and close multidisciplinary coordination are important for optimizing perioperative outcomes in this rare condition.
What the researchers tested
The researchers reported two case reports of postoperative right middle lobe torsion after right upper lobectomy. They describe anesthetic planning for reoperation, including lung isolation with double-lumen tubes, attention to possible airway mucosal edema, and hemodynamic monitoring during release of the torsion.
What worked and what didn't
In the first case, the torsion was irreversible and the lobe had compromised perfusion, so middle lobectomy was needed. In the second case, preserved parenchymal enhancement on imaging allowed detorsion with lobar fixation. Both patients maintained acceptable oxygenation and stable hemodynamics during anesthesia, and there was no evidence of reperfusion-related instability.
What to keep in mind
This is a report of only two cases, so the findings are limited to those experiences. The abstract does not describe comparative data, and it does not provide broader estimates of how often these management strategies succeed beyond these patients.
Key points
- Two cases of right middle lobe torsion occurred after right upper lobectomy.
- Persistent postoperative atelectasis led to repeated bronchoscopy and contrast-enhanced computed tomography.
- One case required middle lobectomy because the torsion was irreversible and perfusion was compromised.
- The other case was managed with detorsion and lobar fixation after preserved enhancement was seen.
- Both patients had acceptable oxygenation and stable hemodynamics during anesthesia.
Disclosure
- Research title:
- Middle lobe torsion after lobectomy required rapid diagnosis and tailored anesthesia
- Authors:
- Mai Akazawa, Yasuhiko Imashuku, Yojiro Tsujimoto, Risa Katsuyama, Yoshihisa Fujino
- Institutions:
- Fukuoka Higashi Medical Center, Fukuoka Higashi Medical Center, Fukuoka Higashi Medical Center, Fukuoka Higashi Medical Center, National Hospital Organization, National Hospital Organization, National Hospital Organization, National Hospital Organization, Shiga University of Medical Science, Shiga University of Medical Science
- Publication date:
- 2026-02-24
- OpenAlex record:
- View
Get the weekly research newsletter
Stay current with scholarly research without reading academic papers — one filtered digest, every Friday.