Abstract: Objective：To discuss the clinical presentations and therapeutic principles of postoperative lobar torsion after video assisted thoracoscopic surgery（VATS）pneumonectomy.Methods：To analyze retrospectively 3 cases of postoperative lobar torsion after VATS right upper lobectomy，including 2 systematic lymph node dissection and 1 lymph node sampling.Results：3 cases were all the postoperative middle lobar torsions.Postoperative radiographs demonstrated atelectasis in 1 patient and atelectasis and consolidation in 2 patients.Bronchoscopy showed different narrowing bronchus orifice of the middle lobe.The diagnosis of lobar torsion was made an average of（3.67±2.52）d（range 1 to 6days）after the initial operation；2 patients underwent direct resection and 1 patient underwent reposition.Average hospitalization was（8.67±4.73）d and range from 5 to 14 days.No Complications happened after reoperation.Conclusion：Complete pulmonary fissure and higher range of motion of the residuary lobe are the major risk factors of postoperative lobar torsion after VATS pneumonectomy.For patients with high suspicion of lobe torsion，reVATS should be performed as quickly as possible.Indirect resection is still preferred if the lung function permits.

Key words: lobe torsion, surgery, reposition