Thoracoscopic Temporary Segmental Bronchus Incision Technique for Fissureless Lobectomy
Tsunezuka, Y.; Fujimori, H.; Tanaka, N.; Tanaka, N.
Kyobu Geka. Japanese Journal of Thoracic Surgery 70(2): 94-99
2017
ISSN/ISBN: 0021-5252 PMID: 28174401 Document Number: 691888
Several thoracoscopic fissureless lobectomy techniques have been reported;however, the indications for the same remain controversial. One of the reasons for conversion to open lobectomy is the swelling or inflammation of lymph nodes between the lobar bronchus and the adjacent pulmonary artery. In this report, we advocate temporary segmental bronchus incision technique(T-BIT)and describe its application for lung cancer patients with fused fissures. T-BIT involves initial segmental bronchus incision before lobar bronchus stapling to safely dissect the lymph nodes between the lobar bronchus and the pulmonary artery. Eight patients who underwent thoracoscopic fissureless lobectomy with T-BIT between August 2014 and August 2016 were included in the study. Five patients underwent left upper lobectomy, one underwent left lower lobectomy, and 2 underwent right middle lobectomy. With T-BIT, complete peribronchial lymph node dissection was easily performed in all patients. There were no intraoperative complications, such as pulmonary artery bleeding or pulmonary injury. The postoperative chest tube drainage time was 2.5±0.5 days. Taken together, T-BIT appears useful for lymph node dissection in thoracoscopic fissureless lobectomy.