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Background: Pneumothorax is a rare but serious complication of septic pulmonary embolism (SPE). SPE is a life-threatening disorder wherein infected thrombi bring infarction of the terminal and small caliber parts of the pulmonary vasculature and develop multiple nodular and cavitary lesions. Interventions other than conservative chest tube drainage for pneumothorax due to SPE have rarely been reported. Here, we present a case of bilateral pneumothorax due to SPE treated with intrapleural minocycline pleurodesis., Case Description: A 72-year-old male patient previously diagnosed as esophageal carcinoma developed metachronous bilateral pneumothorax while treated for brain metastases. Based on blood cultures and chest computed tomography images, he was diagnosed with pneumothorax secondary to SPE due to methicillin-susceptible Staphylococcus aureus bacteremia. Bilateral chest tube drainage was instituted. Continuous air leakage was found bilaterally after chest tube placement. He was treated with broad-spectrum antibiotics based on the susceptibility profile and supportive treatment for sepsis. Approximately 3 weeks later, air leakage significantly reduced. We performed intrapleural minocycline pleurodesis bilaterally to prevent the recurrence of pneumothorax; the left side was firstly treated and the right side was treated 2 weeks later. Both chest tubes were successfully removed two days after procedures. Although the patient finally died of brain metastases 1 month after pleurodesis, he never recurred pneumothorax., Conclusions: Intrapleural minocycline pleurodesis may be one of the useful and efficacious options in terms of treating intractable pneumothorax associated with SPE. Intrapleural minocycline pleurodesis could be a consideration for intractable pneumothorax related to SPE., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-23-1923/coif). S.W. received grants from Boehringer Ingelheim and Nippon Kayaku outside the submitted work, and honoraria for lectures from Lily, Chugai Pharma, Ono Pharmaceutical, Taiho Pharmaceutical, Kyowa Kirin, Takeda Pharmaceutical, AstraZeneca, Novartis Pharma, Bristol-Myers, Daiichi Sankyo, Nippon Kayaku, and Celltrion outside the submitted work. The other authors have no conflicts of interest to declare., (2024 Journal of Thoracic Disease. All rights reserved.)

Background: Robotic systems have been used to enhance the surgeon's dexterity and visualization in endoscopic surgery and thus facilitate refined dissection, suturing, and knot tying. We describe use of the da Vinci surgical system for robotic-assisted thoracoscopic bronchoplasty in patient with centrally located lung cancer., Methods: We used three robotic ports (a 12-mm trocar for the 30°-down camera and two 8-mm trocars for the robotic instrument arms) and one utility incision for assistance and specimen retrieval. Lung isolation were achieved using double-lumen endotracheal tube without carbon dioxide inflation. The bronchoplasty was performed by using 4/0 polydioxanone suture (PDS)., Results: Three cases of robotic-assisted thoracoscopic bronchoplasty (n=3) were performed. Case 1: right upper lobe lobectomy with right main bronchus primary closure; case 2: right upper lobe lobectomy with the anterior wall of the right main bronchus re-anastomosis; case 3: left upper lobe sleeve lobectomy. The surgery and post-operative course were smooth without complication., Conclusions: We suggest that robotic-assisted thoracoscopic surgery offers specific advantages over conventional thoracoscopic surgery with accuracy and safety when doing bronchoplasty., Competing Interests: Conflicts of Interest: The authors have no conflicts of interest to declare.