COVID-19 pneumonia following double-sleeve lobectomy for lung cancer
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CASE REPORT
COVID‑19 pneumonia following double‑sleeve lobectomy for lung cancer Yusuf Inanc1 · Guven Olgac2 · Merih Kalamanoglu Balci3 · Cemal Asim Kutlu1 Received: 12 July 2020 / Accepted: 21 September 2020 © The Japanese Association for Thoracic Surgery 2020
Abstract Here, we report a 54-year-old man who underwent double-sleeve left upper lobectomy for lung cancer and his postoperative course was complicated with COVID-19 pneumonia. Five days after his discharge from hospital, he was re-admitted with mild fever and bilateral multiple ground glass opacities on his chest CT. PCR testing confirmed COVID-19 infection and he was treated according to policies established by our nation’s health authority. He is still receiving adjuvant chemotherapy and remains well at 3 months after the operation. Keywords Double sleeve lobectomy · Postoperative complication · COVID-19 pneumonia Abbreviations COVID-19 Coronavirus disease 2019 CT Computed tomography FDG Fluoro-deoxy glucose GGO Ground glass opacity NSCLC Non-small-cell lung cancer PCR Polymerase chain reaction PET Positron emission tomography SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 VATS Video assisted thoracic surgery
Introduction Dreadful spreading features of the COVID-19 pandemic have rapidly extinguished healthcare sources of many countries regardless of their development level. This has greatly influenced the treatment algorithms of lung cancer with * Yusuf Inanc [email protected] 1
Department of Thoracic Surgery, Bahcesehir University School of Medicine, Merdivenköy, 23 Nisan Sok. No:17, Kadıköy, 34732 Istanbul, Turkey
2
Department of Thoracic Surgery, Yedikule Chest Diseases and Thoracic Surgery Research and Teaching Hospital, Istanbul, Turkey
3
Department of Pulmonology, Bahcesehir University School of Medicine, Istanbul, Turkey
resultant decrease in number of elective surgeries as hospital admissions of COVID-19 cases have increased [1, 2]. It has, in turn, forced thoracic surgeons to prioritize surgical referrals more responsibly according to their individualized stage-based treatment needs [1–3]. In this respect, decisionmaking process of each patient became a challenging one as many of them are susceptible to this infection throughout the peri-operative period. Considering that postoperative outcome and survival rates are significantly better in patients undergoing lung sparing procedures for NSCLC and unnecessarily extended resections almost invariably lead to detrimental consequences [4], every effort should devotedly be made to preserve as much lung tissue as possible. Here, we report such a case who underwent double-sleeve left upper lobectomy during the early days of COVID-19 pandemic in Turkey.
Case A 54-year-old male was presented with unproductive cough lasting for 4 weeks. Physical examination was otherwise normal, but CT of chest revealed a 6 cm lobulated mass surrounding the left upper lobe bronchus and possibly invading the left main pulmonary artery. At bronchoscopy, a tumor originating from
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