Lobectomy for destroyed lung in quadriplegic patients

Background. Sixty-seven percent of quadriplegic patients after spinal cord injury (SCI) develop respiratory complications, which leads to death in one third. Preventive measures may fail to avoid parenchymal destruction and possible septic complications. Methods. Three quadriplegic patients (C3-C6 level), with destroyed lower lobes and incontrollable septic symptoms, were subjected to lobectomy. Results. Neither operative morbidity nor mortality was observed. All patients were discharged home without ventilatory assistance, and were symptom-free. Conclusions. When the endobronchial chronic infection calls for repeated fiberoptic bronchoscopies to clear the bronchial tree, the parenchymal destruction is limited to one lobe of the lung, and there is evidence of impending septic complications, lobectomy may be indicated in quadriplegics to eradicate the source of infection.