Successful Bronchial Replacement Using a Thoracodorsal Artery Perforator Flap

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Respiratory Medicine

Background:

• Pneumonectomy carries high morbidity and mortality risks, especially in patients with compromised lung function.
• Sleeve lobectomy is an alternative but can be technically challenging with extensive bronchial involvement.

Purpose of the Study:

• To describe a novel surgical approach for right upper lobe lung cancer with intermediate bronchial trunk involvement in a patient with impaired lung function.
• To report the successful application of a thoracodorsal artery perforator flap and endostent for bronchial reconstruction.

Main Methods:

• A right upper sleeve lobectomy was performed.
• Bronchial reconstruction was achieved using a thoracodorsal artery perforator flap.
• A temporary endostent was utilized during the reconstruction process.

Main Results:

• The patient with impaired lung function and right upper lobe lung cancer involving the intermediate bronchial trunk was treated successfully.
• Favorable clinical outcomes were observed post-surgery.
• No recurrence of lung cancer was noted in the 4 years following the operation.

Conclusions:

• Right upper sleeve lobectomy with bronchial replacement using a thoracodorsal artery perforator flap and endostent is a viable and effective treatment for selected lung cancer patients with impaired lung function.
• This technique offers a promising alternative to pneumonectomy in complex cases, achieving durable oncological and functional results.