Post-lobectomy airways complications

Abstract

Post-lobectomy airways complications are associated with significant morbidity and mortality. Lobar torsion, bronchopleural fistula and bronchovascular fistula pose a challenge to the clinician to secure timely diagnosis and intervention in order to improve outcomes. We discuss the aetiology, presentation, prevention and management of lobar torsion, bronchopleural and bronchovascular fistula and anastomotic complications following lobar resection. Judicious surgical technique and effective employment of preventative strategies may reduce the risk of airway complications. Presentation of post-lobectomy airway complications may be non-specific but are often rapidly progressive. Computed tomography (CT) and bronchoscopy are essential diagnostic tools to support clinical suspicion. The pillars of successful management of post-lobectomy airway complications are a high degree of clinical suspicion, prompt investigation and early intervention. These are essential to minimise perioperative mortality and long-term sequelae. Minimal access surgery and novel endobronchial techniques have expanded the treatment options for post-lobectomy bronchial complications in selected patients.