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Successful Right Middle Lobe Resection after Left Pneumonectomy with Selective Lobar Blockade Assisted by Preoperative Coronal Multiplanar Reformation Images on 64 Slice Multidetector Computed Tomography

Junko Ichikawa, Mitsuharu Kodaka, Masato Endo, Keiko Nishiyama, Masahiro Mae, Yasuko Tomizawa, Makiko Komori and Makoto Ozaki

Selective isolation of a pulmonary lobe is indispensable in patients who have undergone pneumonectomy and require surgery of the remaining lung. The use of a bronchial blocker is associated with the following problems: 1) placement can require considerable time; 2) suction is often necessary to expedite lung collapse; and 3) the position of the blocker sometimes must be corrected intraoperatively with the use of fiberoptic bronchoscopy. To solve these problems, it is useful for physicians to simulate the positioning of blockers on preoperative coronal multiplanar reformation images obtained by 64- slice multidetector computed tomography (MDCT) and to be familiar with airway devices for lung isolation. We describe the use of selective lobar blockade with an endobronchial blocker assisted by preoperative coronal multiplanar reformation images on 64-MDCT in a patient who had undergone a left pneumonectomy.