{
  "abstract": "INTRODUCTION: Lung transplantation combined with pectus excavatum repair has been reported in selected patients with severe pectus excavatum to expand the restricted thoracic cavity and facilitate graft accommodation. However, the safe implementation of this surgical strategy may be challenging in patients with extensive pleural adhesions after repeated pleurodeses, because of the increased risk of postoperative bleeding and re-thoracotomy.\n\nCASE PRESENTATION: A 15-year-old boy with interstitial lung disease, secondary pulmonary hypertension, severe pectus excavatum, and multiple prior bilateral pleurodeses underwent deceased-donor bilateral lung transplantation using a planned delayed chest closure (DCC) strategy. Preoperative CT showed marked thoracic deformity with a Haller index of 9.1 and a leftward mediastinal shift. Because extensive pleural adhesions were expected to complicate graft implantation and hemostasis and increase the risk of re-thoracotomy for postoperative bleeding, a 2-stage strategy consisting of planned DCC followed by pectus bar placement at definitive chest closure was established at the time of transplant listing in collaboration with an external pectus specialist. Bilateral lung transplantation was performed under venoarterial extracorporeal membrane oxygenation support, followed by temporary chest closure. At the second-stage operation on POD 2, 2 pectus bars were placed, and additional graft volume reduction was performed, allowing definitive chest closure without hemodynamic compromise. The patient was discharged home on POD 69 without wound complications or implant-related infections.\n\nCONCLUSIONS: This case suggests that lung transplantation may be feasible in carefully selected patients with severe pectus excavatum and extensive pleural adhesions, with appropriate multidisciplinary planning. A preplanned 2-stage strategy incorporating DCC and pectus bar placement at definitive chest closure represents a potential option for such complex cases.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan",
    "Division of Organ Transplantation, Tohoku University Hospital, Sendai, Miyagi, Japan",
    "Department of Plastic and Reconstructive Surgery, Sendai City Hospital, Sendai, Miyagi, Japan"
  ],
  "article_type": "case report",
  "arxiv": null,
  "author_total": 12,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Yusuke Nakano"
    },
    {
      "affs": [
        0
      ],
      "name": "Tatsuaki Watanabe"
    },
    {
      "affs": [
        0
      ],
      "name": "Hirotsugu Notsuda"
    },
    {
      "affs": [
        0
      ],
      "name": "Takuya Ikushima"
    },
    {
      "affs": [
        0
      ],
      "name": "Sakiko Kumata"
    },
    {
      "affs": [
        0
      ],
      "name": "Ken Onodera"
    },
    {
      "affs": [
        0
      ],
      "name": "Yui Watanabe"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Takashi Hirama"
    },
    {
      "affs": [
        0
      ],
      "name": "Takaya Suzuki"
    },
    {
      "affs": [
        0
      ],
      "name": "Hisashi Oishi"
    },
    {
      "affs": [
        2
      ],
      "name": "Takashi Kochi"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Yoshinori Okada"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/ehqfzefc2spv9.bib",
  "cited_by": 0,
  "doi": "10.70352/scrj.cr.26-0685",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13730626/",
  "id": "ehqfzefc2spv9",
  "issns": [
    "2198-7793"
  ],
  "landing_url": "https://doi.org/10.70352/scrj.cr.26-0685",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Case Report"
    ],
    [
      "openalex",
      "2746|Pectus Deformity Diagnosis and Treatment"
    ]
  ],
  "openalex": "W7224813939",
  "pdf_url": "https://www.jstage.jst.go.jp/article/scrj/12/1/12_cr.26-0685/_pdf",
  "pmcid": "PMC13730626",
  "pmid": "42979411",
  "published": "2026-10-31",
  "publisher": "Japan Surgical Society",
  "ris": "https://research.draconitic.com/paper/ehqfzefc2spv9.ris",
  "sources": [
    {
      "first_seen": "2026-11-07T12:23:08Z",
      "native_id": "PMC13730626",
      "source": "pmc",
      "url": "https://doi.org/10.70352/scrj.cr.26-0685"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Pectus Deformity Diagnosis and Treatment",
      "subfield": "surgery"
    }
  ],
  "title": "Lung Transplantation with Planned Delayed Chest Closure in Severe Pectus Excavatum after Multiple Pleurodeses: A Case Report",
  "title_text": "Lung Transplantation with Planned Delayed Chest Closure in Severe Pectus Excavatum after Multiple Pleurodeses: A Case Report",
  "type": "peer-reviewed",
  "updated_at": "2026-11-07T12:23:08Z",
  "url": "https://research.draconitic.com/paper/ehqfzefc2spv9",
  "venue": "Surgical Case Reports",
  "versions": []
}