Abstract

Lung resection surgery after a prior lobectomy or pneumonectomy is becoming more prevalent. Elevated shunt fractions and reduced functional lung parenchyma complicate one-lung ventilation in the patient with a prior contralateral lobectomy. Meanwhile, lung resection after pneumonectomy requires reliance on the solitary, surgical lung for adequate oxygenation and ventilation without impeding surgical progress. These challenges require appropriate preoperative investigations and planning to facilitate a technique that balances the need for adequate gas exchange and lung injury prevention with the desire for sufficient exposure to allow for a complete surgical resection and optimal oncologic outcomes.

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