Bronchoplasty to adjust mismatches in the proximal and distal bronchial stumps during bronchial sleeve resection of the left lower lobe and lingular division.

Abstract

We treated two lung cancer patients with metastatic hilar lymph node at the left lower lobe, involving the bifurcation of the left upper- and lower lobar bronchi and the lingular pulmonary artery. After induction chemoradiotherapy, we performed a bronchial sleeve resection of the left lower lobe and lingular division. In these cases, anastomosis of the left superior divisional and main bronchial stumps was necessary, which required correction of an orifice size mismatch. For this purpose, we performed different procedures on each patient. In Procedure 1, we edged the larger superior divisional bronchial stump with the partially excised walls of the upper lobar and the lingular divisional bronchi. In Procedure 2, we reefed the membranous portion of the main bronchus with adjusting stitches. Our procedure is useful for adjusting mismatch of the bronchial stump in anastomosis in a bronchial sleeve resection of the left lower lobe and lingular division.