Answer:

Serious complications after lobectomy include lobar collapse, massive hemorrhage caused by loosening of pulmonary vessels ligatures, bronchopleural fistula from disruption of a bronchial stump, and pulmonary torsion and infarction resulting from increased mobility of the remaining lobe. Mediastinal shift, pleural effusion, hemothorax, chylothorax, empyema, and pulmonary edema can also occur. Deep venous thrombosis can lead to pulmonary embolism.

Pneumonectomy can be complicated by supraventricular arrhythmias, acute respiratory insufficiency, nerve injuries (phrenic, vagus, or recurrent laryngeal) during radical hilar dissection or excision of mediastinal tumors, cardiac herniation (in the case of intrapericardial approach), acute right heart failure, and right-to-left shunting across a patent foramen ovale as a result of increased pulmonary vascular resistance and increased right ventricular pressure. Postpneumonectomy syndrome is a rare complication characterized by mediastinal shift ipsilateral to the side of surgery with herniation of the hyperinflated lung in the same direction.

• Slinger PD, ed. Principle and Practice of Anesthesia for Thoracic Surgery. Cham, Switzerland: Springer; 2019:885-923.