Lobectomy vs Pneumonectomy
The similarities:
1. Both have thoracotomy scars.
2. Both have reduced chest expansion and reduced AE.
The differences:
1. The signs of lobectomy are confined to lobe which is removed. The signs are similar to pleural effusion except it is not stony dull.
2. The signs of pneumonectomy are extensive i.e. involve the whole lung. The side involved would be flatten. It is similar to whole lung collapse.
3. Normally, the tracheal is central in lobectomy except for upper lobe. The tracheal is almost always shifted in pneumonectomy.
Labels: Respiratory
posted by Dr. David Teoh @ 4/04/2006 07:28:00 PM
3 Comments:
I beg to differ with clinical findings in lobectomy .
In upper lobectomy , the lower lobe fills up the space left in the upper lobe thereby pulling up the diaphragm up , hence a raised diaphragm on side of lobectomy and clinical signs ( dullness, reduced vocal resonance) are confined to lower chest zones. The findings are same in lower lobectomy
I think there will alway be a little deviation of the trachea to the side of the lobectomy.Because just like lung collapse there is loss of volume and the expanded contralateral lungs will push the mediasternum to the otherside.And the trachea deviation can even be gross as in pneumonectomy because of compensatory emphysema of the contralateral lung.
In Pneumonectomy as the other lung shift towards empty hemithorax their will be a area of bronchial breathing over the UZ of same side as displced trachea is underneeth.
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