Surgical therapy of middle lobe syndrome: A report of 80 cases

Objective To explore the clinical manifestation and surgical treatment of the middle lobe syndrome.Methods A total of 80 patients with middle lobe syndrome,received and cured from June 1996 to August 2010 and conformed by pathological studies,were made to undergo retrospective analysis.Results Among the 80 cases(47 males and 33 females,aged 5 to 81 years with an average age of 54.5 years) of middle lobe syndrome,52 cases showed five big clinic symptoms that include cough,expectoration,fever,chest pain,or hemoptysis,whereas 28 cases showed no symptoms.The chest x-ray result showed that the right heart edge appeared fuzzy or atelectasis triangle appeared shadowy.The chest enhanced CT scan showed swollen lymph nodes at the root of the middle lobe,and tumors could be detected in the lumen of right middle lobe bronchus.The positive rate of fiber-optic bronchoscopy was 46.6%(21/45).The surgical procedures included simple lobectomy in 47 cases(58.8%),bilobectomy in 28 cases(35%,including sleeve resection of four cases),right pneumonectomy in one case(1.2%),and partial resection in four cases(5%).Successful operation had been achieved in all the cases,and no occurrence of death was noted.Conclusions The clinical manifestations of the middle lobe syndrome are non-specific.Fiber-optic bronchoscopy should be listed as a routine examination.The best treatment for the middle lobe syndrome is to perform a surgery.