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

## TL;DR

This case report shows that SF6 gas is effective in treating post-pneumonectomy syndrome and reduces the need for frequent medical interventions.

## Contribution

Demonstrates the long-term effectiveness of SF6 as a treatment for post-pneumonectomy syndrome.

## Key findings

- SF6 injections successfully managed mediastinal shift and bronchial obstruction in a patient with PPS.
- The interval between SF6 injections increased from 3 to 11 months, indicating improved intrathoracic condition.
- SF6 gas administration was found to be safe and effective for PPS treatment.

## Abstract

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.

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 (SF6) injections were successfully used to manage her condition. Over the course of follow-up, the interval between SF6 injections was extended from 3 to 11 months, indicating an improvement in the intrathoracic condition.

This case illustrates the efficacy of SF6 gas in treating PPS and in reducing the frequency of medical interventions. SF6 gas administration is safe and effective for the treatment of patients with PPS.