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[Longitudinal bronchotomy on the pars membranacea for endoscopic foreign body extraction]
1Dipartimento di Chirurgia, Università degli Studi, Pavia. nazaris@tin.it
Abstract:
Purpose of this paper is to report a case of foreign body obstructing the middle lobe bronchial origin, surgically removed through a longitudinal bronchotomy on the pars membranacea, reached by passing posteriorly to the lung. Anatomical considerations suggest that longitudinal bronchotomy on the pars membranacea of the main bronchial axis (stem bronchi, intermedius br (right), and lower lobar bronchus) gives direct visualization from inside also of foreign bodies sited into the lobar bronchi (sup, middle and lingula), allowing an easy bronchotomy repair, without lumen distortion or stenosis. Since the pulmonary artery is not in contact with this pars membranacea, broncho-arterial fistula in case of suture line dehiscence is quite improbable.
Insights
A novel surgical approach successfully removed a foreign body from the middle lobe bronchus using a longitudinal bronchotomy. This technique offers direct visualization and minimizes risks like stenosis and broncho-arterial fistula.
Area of Science:
- Thoracic Surgery
- Pulmonology
- Medical Case Reports
Background:
- Foreign body aspiration can cause bronchial obstruction, necessitating effective surgical interventions.
- Traditional bronchotomy techniques may lead to complications such as lumen distortion and stenosis.
Observation:
- A case involving a foreign body obstructing the middle lobe bronchial origin is presented.
- Surgical removal was achieved via a longitudinal bronchotomy on the pars membranacea, accessed posteriorly.
Findings:
- The longitudinal bronchotomy technique provides direct internal visualization of foreign bodies within lobar bronchi.
- This method facilitates straightforward bronchotomy repair without causing lumen distortion or stenosis.
Implications:
- This approach offers a safe and effective method for managing bronchial foreign bodies, particularly in the middle lobe.
- The anatomical positioning of the pars membranacea reduces the risk of broncho-arterial fistula formation post-suture.