Postoperative Outcome of Procedure for Middle Lobe Torsion Involving Right Upper and Lower Bilobectomy in Multiple Primary Lung Cancers

We present the case of a 79-year-old man with synchronous multiple primary lung cancers who underwent right upper and right lower bilobectomy. In the bilobectomy, the pedicled pericardial fat was fixed to the middle lobe hilum and sutured to the lower lobe bronchial stump. Polyglycolic acid sheets and fibrin glue were used to anatomically position and adhere the expanded middle lobe to the diaphragm. He recovered uneventfully. An examination 2 years later showed that he was well and had not experienced dyspnea or recurrence. Chest computed tomography revealed considerable expansion and emphysematous changes in the middle lobe, but his pulmonary function was well preserved.