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Availability of lobe-selective bronchial blockade for video-assisted thoracic surgery: an initial experience with
T Morikawa1, H Sugiura, M Kaji
1Surgical Oncology, Division of Cancer Medicine, Anesthesiology, and Critical Care Medicine, and Second Department of Surgery, Hokkaido University Hospital, North 15, West 7, Kita-ku, Sapporo 060-8638, Japan. t-morika@med.hokudai.ac.jp
Background:
Stable oxygenation and sufficient collapse of the lung are essential for video-assisted thoracic surgery (VATS). We performed the lobe-selective lung collapse technique with VATS for patients who had deteriorated lung function.
Methods And Results:
CASE 1: A 75-year-old man who had undergone thoracoplasty showed spontaneous pneumothoraces in the contralateral side. Bullae were stapled successfully under complete isolation and collapse of diseased lobe. CASE 2: A 57-year-old woman who had undergone left lower lobectomy for lung cancer presented with another lung cancer in the right lower lobe. The right lower lobe bronchus was closed selectively, and basal segmentectomy was performed. CASE 3: A 60-year-old woman who had lost left lung function presented with right-side spontaneous pneumothoraces. The right upper lobe was collapsed selectively, and bullectomy was performed.
Conclusion:
Lobe-selective bronchial blockade may be beneficial when VATS is performed for selected patients with deteriorated lung function.