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Strategy for lung parenchyma-sparing bronchial resection: a case series report
Akihiro Ohsumi1, Hidenao Kayawake1, Yoshito Yamada1
1Department of Thoracic Surgery, Kyoto University Hospital, Kyoto, Japan.
Interactive Cardiovascular and Thoracic Surgery
|June 14, 2022
Summary
Lung parenchyma-sparing bronchial resections are rare. This study details surgical strategies for central airway sleeve resection without lung removal, highlighting bronchoplasty as a viable treatment in expert hands.
Area of Science:
- Thoracic Surgery
- Pulmonary Medicine
- Surgical Oncology
Background:
- Lung parenchyma-sparing bronchial resection is an uncommon surgical approach.
- The choice of operative procedure for bronchial stenosis is dictated by its cause and location.
Purpose of the Study:
- To present six cases of lung parenchyma-sparing bronchial resection.
- To discuss various surgical strategies for sleeve resection of the central airway without necessitating lung resection.
Main Methods:
- Bronchoplasty was performed for main bronchus and truncus intermedius stenosis using a posterolateral approach.
- Resection involved the right main bronchus, right lateral tracheal wall, and half the carina, followed by anastomosis.
- Tumor removal from the left lobar bronchus was achieved via transient division of the adjacent pulmonary artery.
Main Results:
- Sleeve resection of the central airway was successfully performed in six patients without lung resection.
- Specific techniques included bronchoplasty, oblique resection of the right main bronchus and carina, and tumor excision via pulmonary artery division.
Conclusions:
- Bronchoplasty can be a definitive treatment for central airway stenosis, particularly in experienced centers.
- Challenges such as post-transplant stenosis and malacia can be managed with bronchoplasty.
