Left main bronchus rupture during video-assisted thoracoscopic surgery resection of a bronchogenic cyst

Video-assisted thoracoscopic surgery (VATS) is an approach to resection of bronchogenic cysts (BC) which is effective and viable. There may be complications as a result of pericystic adhesions to neighboring structures during dissection. This report describes an unusual case of an operative complication, the rupture of the main left bronchus. The initial VATS approach was converted into a right thoracotomy to remove the cyst and suture the bronchus once adequate exposure was obtained. Bronchus reconstruction failed and a few hours later, it was necessary to perform a left thoracotomy. A left pneumonectomy was required after the attempt to reconstruct the anastomosis was ruled out. The conclusion is that great care should be taken when using VATS approach for BC with adhesions.