2020 Volume 34 Issue 2 Pages 178-181
We herein present the case of a 68-year-old man. He underwent left lower lobectomy for lung cancer. In the following year, he experienced right tension pneumothorax twice, and underwent thoracic drainage as conservative treatment. Three days after discharge, he experienced tension pneumothorax and was re-admitted to our hospital. On admission, his consciousness level was E2-V3-M5, according to the Glasgow Coma Scale, and he showed low oxygen saturation levels. Considering the severity and short interval of recurrence, we decided to perform surgery. However, his pulmonary function was inadequate because of combined pulmonary fibrosis and emphysema and post-pulmonary resection status associated with lung cancer.
Therefore, we decided to perform video-assisted thoracoscopic bullectomy with extracorporeal membrane oxygenation (ECMO) to maintain the oxygen levels during the operation in cooperation with the cardiovascular surgery department as well as other departments. The operation was successfully performed, and the postoperative course was uneventful. Furthermore, he was discharged on postoperative day 10. He remained stable without the recurrence of pneumothorax or exacerbation of interstitial pneumonia.
We consider that ECMO is an effective approach to provide respiratory support for patients with a poor pulmonary function undergoing thoracic surgery.
