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Right Lower Sleeve Lobectomy: Detailed Technique and Perioperative Patient Management
Hidetoshi Inoue1, Takuma Tsukioka1, Nobuhiro Izumi1
1Department of Thoracic Surgery, Osaka Metropolitan University, Osaka, Osaka, Japan.
Purpose:
This report reviews our experience with right lower sleeve lobectomy and describes our technique and approach to perioperative patient management.
Methods:
We retrospectively reviewed 11 patients who underwent right lower sleeve lobectomy for lung cancer. Surgical techniques and perioperative management were also investigated.
Results:
Bronchoplasty was performed using 4-0 absorbable monofilament sutures. The deepest portion was anastomosed using continuous sutures; interrupted sutures were used for the more superficial portions. The truncus intermedius and right middle lobe bronchus should be anastomosed in a natural position. Anastomosis patency was confirmed using intraoperative bronchoscopy. Separation of the right upper and middle lobes and pericardiotomy at the inferior edge of the superior pulmonary vein are useful for mobilizing the right middle lobe. Death during hospitalization and treatment-related death did not occur. One patient developed pneumonia, and another developed a bronchopleural fistula.
Conclusion:
We reported our technique of right lower sleeve lobectomy and our approach to perioperative patient management. Sharing knowledge is essential to completing this rare surgery.
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