SF6 is a useful expander for post-pneumonectomy syndrome in the long-term course: a case report

Background Post-pneumonectomy syndrome (PPS) is a rare but serious condition that can occur after pneumonectomy. It is characterized by a mediastinal shift towards the vacated hemithorax, which can potentially lead to respiratory failure. The management of PPS poses a clinical challenge, especially in the context of the limited availability of certain therapeutic devices due to regulatory restrictions in Japan. Case presentation A 36-year-old female with stage IB non-small cell lung cancer underwent left pneumonectomy. Approximately 2 years later, she developed dyspnea. After consulting with our hospital, subsequent imaging revealed an extreme mediastinal shift causing bronchial obstruction. Emergency thoracotomy and subsequent sulfur hexafluoride (SF 6 ) injections were successfully used to manage her condition. Over the course of follow-up, the interval between SF 6 injections was extended from 3 to 11 months, indicating an improvement in the intrathoracic condition. Conclusions This case illustrates the efficacy of SF 6 gas in treating PPS and in reducing the frequency of medical interventions. SF 6 gas administration is safe and effective for the treatment of patients with PPS.