title: Preceding bronchial cutting for exposure of the pulmonary artery buried in scar tissue after chemoradiotherapy.
abstract: It is often difficult to expose the pulmonary artery buried in a scar tissue, especially in lung cancer patients that responded well to neoadjuvant chemoradiotherapy. Difficulty to access pulmonary artery branches may lead to potentially unnecessary pneumonectomy. To complete lobectomy in such cases, a technique with preceding bronchial cutting for exposure of the pulmonary artery is presented. After dissecting the pulmonary vein, the lobar bronchus is cut from the opposite side of the pulmonary artery with scissors. The back wall of the lobar bronchus is cut using a surgical knife from the luminal face, which can expose the pulmonary artery behind the bronchial stump and then complete lobectomy. Fourteen patients have been treated using the present technique, enabling complete resection by lobectomy (including sleeve lobectomy in 3 patients) without major bleeding. The present procedure can expose pulmonary artery buried in scar tissue, resulting in making the lobectomy safer.
authors: Department of Thoracic Surgery, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba, 296-8602, Japan. hnomori@qk9.so-net.ne.jp.
authors: Hiroaki
authors: H
authors: Nomori
authors: Department of Thoracic Surgery, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba, 296-8602, Japan.
authors: Yue
authors: Y
authors: Cong
authors: Department of Thoracic Surgery, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba, 296-8602, Japan.
authors: Hiroshi
authors: H
authors: Sugimura
mesh_terms: D000368:Aged; D001980:Bronchi / Q000601:surgery*; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D059248:Chemoradiotherapy / Q000009:adverse effects; D002921:Cicatrix / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000009:adverse effects; D011013:Pneumonectomy / Q000379:methods*; D011651:Pulmonary Artery / Q000601:surgery*; D011667:Pulmonary Veins / Q000601:surgery; D014057:Tomography, X-Ray Computed
keywords: Bronchial resection; Lung cancer; Neoadjuvant chemoradiotherapy