Year : 2014  |  Volume : 8  |  Issue : 3  |  Page : 108-111

Management of bronchial dehiscence immediately following video-assisted thoracoscopic lobectomy

1 Department of Anesthesia and ICU, Ain Shams University, Cairo, Egypt; Department of Cardiothoracic Anesthesia, Newcastle Upon Tyne Hospital, Newcastle Upon Tyne, UK
2 Department of Cardiothoracic Anesthesia, Newcastle Upon Tyne Hospital, Newcastle Upon Tyne, UK

Correspondence Address:
Mostafa Eladawy
DESA, Department of Cardiothoracic Anesthesia, Freeman Hospital, 52 Church Lane, Newcastle Upon Tyne, NE77DN, UK

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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1687-9090.153414

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Bronchial dehiscence is a rare complication following lung surgery. It might be life threatening if not diagnosed and treated immediately and appropriately. This case report high-lights an immediate presentation of bronchial dehiscence in a patient after video assisted thoracoscopic lobectomy. The complication was managed initially with an emergency insertion of single lumen tube which was swapped later on to double lumen tube for a better control of the ventilation.Ventilation improved when the single lumen tube was exchanged for a double lumen tube and the patient was taken back to the Operating theatre for repair and suturing of bronchial stump.In conclusion, leakage testing inside the operating room must be given full attention and should warrant a thorough revision and reassessment of all the stumps by the surgeons, but exclusion of the leak intraoperatively does not guarantee prevention of its occurence postoperatively. Dislodgement of staples can happen and leads to deleterious effects if not treated promptly. Respiratory distress, arterial hypoxia and chest drain bubbling immediately after lung surgery should be managed with fiberoptic bronchoscopy followed by immediate intubation with double lumen tube and exclusion of the operated lung.

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