[Suturing left main bronchus in difficult lung resection for repeated and massive hemoptysis]

Area of Science:

• Thoracic Surgery
• Pulmonary Medicine
• Vascular Surgery

Background:

• A 79-year-old male presented with recurrent, massive hemoptysis secondary to bronchiectasis.
• The patient had a complex surgical history, including left upper lobectomy and descending aortic replacement for Stanford type B aortic dissection.

Observation:

• Surgical occlusion of the left main bronchus via median sternotomy was performed.
• Completion pneumonectomy was deemed unsuitable due to the patient's advanced age, poor physiological state post-hemorrhagic shock, and surgical complexities including an anastomotic aneurysm.

Findings:

• The patient's postoperative recovery was uneventful, with discharge on postoperative day 16.
• No subsequent pneumonia or empyema was observed.
• The patient died suddenly from an unknown cause 1.5 years after the procedure.

Implications:

• Bronchial occlusion by suturing is a viable alternative for managing massive hemoptysis in patients with bronchiectasis when lung resection is contraindicated.
• This technique can be particularly useful in cases with challenging prior surgical interventions and comorbidities.