Telescoping bronchial anastomosis for extended sleeve lobectomy

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Presentation transcript:

Telescoping bronchial anastomosis for extended sleeve lobectomy Shinichiro Miyoshi, MD, PhD, Motohiko Tamura, MD, PhD, Osamu Araki, MD, Naoko Yoshii, MD, PhD, Yoko Karube, MD, PhD, Norio Seki, MD, Hideo Umezu, MD, Satoru Kobayashi, MD, PhD, Hiromi Ishihama, MD, Sensuke Nagai, MD, PhD, Noriyoshi Sawabata, MD, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 132, Issue 4, Pages 978-980 (October 2006) DOI: 10.1016/j.jtcvs.2006.05.055 Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Appearance of tumor on computed tomographic scan and operative findings. A and B, Computed tomographic images show a large mass shadow, 4 × 5 cm in size, in the posterior segment of the upper lobe (S2) extending down to the lower lobe. C, A tumor originating in S2 is shown invading the outer wall of the intermediate bronchus. D, A recurrent branch of the pulmonary artery to the posterior segment of the upper lobe (A2b) and a branch of the pulmonary artery to the superior segment of the lower lobe (A6) show tumor invasion. Heavy solid lines in C and D demonstrate divided sites. ULB, Upper lobe bronchus; MLB, middle lobe bronchus; B6, superior segmental bronchus of the lower lobe; BB, basal bronchus of the lower lobe; LAPA, large anterior pulmonary arterial branch of the upper lobe; A2b, recurrent pulmonary arterial branch to the posterior segment of the upper lobe; A6, pulmonary arterial branch to the superior segment of the lower lobe; A3, pulmonary arterial branch to the anterior segment of the upper lobe; MLPA, middle lobe pulmonary artery; BPA, basal segmental pulmonary arterial branch. The Journal of Thoracic and Cardiovascular Surgery 2006 132, 978-980DOI: (10.1016/j.jtcvs.2006.05.055) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Appearance of bronchial anastomosis. A and B, Two stitches were used in the membranous part of the main bronchial stump, and then a telescoping bronchial anastomosis was performed with interrupted sutures. C, Completed anastomoses of the bronchus and pulmonary artery are shown. D, Flexible fiberoptic bronchoscopic image shows the anastomotic site 10 months after the operation. The Journal of Thoracic and Cardiovascular Surgery 2006 132, 978-980DOI: (10.1016/j.jtcvs.2006.05.055) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions