Wedge bronchoplastic lobectomy for non–small cell lung cancer as an alternative to sleeve lobectomy Seong Yong Park, MD, Hyun-Sung Lee, MD, PhD, Hee-Jin.

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Wedge bronchoplastic lobectomy for non–small cell lung cancer as an alternative to sleeve lobectomy Seong Yong Park, MD, Hyun-Sung Lee, MD, PhD, Hee-Jin Jang, MD, Jungnam Joo, PhD, Moon Soo Kim, MD, Jong Mog Lee, MD, Jae Ill Zo, MD, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 143, Issue 4, Pages 825-831.e3 (April 2012) DOI: 10.1016/j.jtcvs.2011.10.057 Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 An extensive wedge bronchoplastic lobectomy. A, The intraoperative findings for a wedge bronchoplastic right upper lobectomy. The right upper lobe bronchus and bronchus intermedius were resected into a wedge shape. B, A schematic illustration of a wedge bronchoplastic lobectomy. After the wedge resection of the bronchus, the right upper lobe was removed, and the remnant bronchus was closed. To prevent folding of the remainder of the bronchus into the lumen of the bronchus, additional sutures can be added to the remainder of bronchus. C, A 3-dimensional reconstruction image after a wedge bronchoplastic right upper lobectomy. The remainder of the bronchus (arrow at the plication site) was folded outside the lumen of the bronchus. In this case, the folded bronchus did not result in narrowing of the bronchial lumen. SVC, Superior vena cava; RML, right middle lobe; RLL, right lower lobe; BI, bronchus intermedius. The Journal of Thoracic and Cardiovascular Surgery 2012 143, 825-831.e3DOI: (10.1016/j.jtcvs.2011.10.057) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Survival curves. A, Overall survival according to nodal status. B, Freedom from local recurrence according to nodal status. C, Freedom from locoregional recurrence according to nodal status. CI, Confidence intervals. The Journal of Thoracic and Cardiovascular Surgery 2012 143, 825-831.e3DOI: (10.1016/j.jtcvs.2011.10.057) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

Figure E1 CONSORT diagram of the patients in this study. The Journal of Thoracic and Cardiovascular Surgery 2012 143, 825-831.e3DOI: (10.1016/j.jtcvs.2011.10.057) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

Figure E2 The postoperative bronchoscopic findings. A, A normal finding after wedge bronchoplastic lobectomy. B, Mild ischemia at the bronchoplasty site without luminal narrowing after a wedge bronchoplastic right upper lobectomy. C, Moderate ischemia and luminal narrowing at the bronchoplasty site after a wedge bronchoplastic left upper lobectomy. In contrast to the circumferential stricture after a sleeve lobectomy, the remnant portion of the bronchus is viable, and patency is preserved. D, Severe ischemia and necrosis at the bronchoplasty site after left upper bronchoplastic lobectomy. This lesion gradually became pinpoint, and the patient eventually received balloon dilatation. (Arrow = bronchoplasty site.) The Journal of Thoracic and Cardiovascular Surgery 2012 143, 825-831.e3DOI: (10.1016/j.jtcvs.2011.10.057) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

Figure E3 The outcomes for the patients who showed dysplasia, carcinoma in situ and carcinoma in the permanent pathology reports. CIS, Carcinoma in situ; BPF, bronchopleural fistula; Tx, therapy; RTx, radiotherapy; CTx, chemotherapy. The Journal of Thoracic and Cardiovascular Surgery 2012 143, 825-831.e3DOI: (10.1016/j.jtcvs.2011.10.057) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

Figure E4 Survival curves between wedge bronchoplasty and sleeve lobectomy. A, Overall survival according to the surgical approaches. B, Freedom from locoregional recurrence according to the surgical approaches. CI, Confidence intervals. The Journal of Thoracic and Cardiovascular Surgery 2012 143, 825-831.e3DOI: (10.1016/j.jtcvs.2011.10.057) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions