"middle lobe syndrome" which was described by Graham and associates at first is always caused by external bronchial compression by lymph nodes. Although the patients may not present any symptom, the most common presenting symptoms were cough,
dyspnea,
fever, hemoptysis, and chest pain. Diagnostic procedures includ chest X-ray bronchoscopy, brochography, chest CT, and the principal finding is the contracted middle lobe which is usually airless.
We experienced fifteen cases of middle lobe syndrome from April 1990 to May 1995. Eleven patients were treated surgically. The surgical candidates for middle lobe syndrome are suspicious malignancy, fixed bronchiectasis, bronchostenosis,
intractable to
medical treatment, recurrent infection. Operations were right middle lobectomy(8), right middle and lower bilobectomy(2), right upper and middle bilobectomy(1).
Postoperative histological findings were tuberculosis in six, chronic inflammation in three, malignancy in one, and focal hemorrhage in one. There were two cases of postoperative complications which were postoperative atelectasis and hepatopathy.
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