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J Thorac Cardiovasc Surg 2006;132:978-980
© 2006 The American Association for Thoracic Surgery

Brief Communication

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

Department of Cardiothoracic Surgery, Dokkyo University School of Medicine, Tochigi, Japan.

Received for publication April 27, 2006; revisions received May 1, 2006; accepted for publication May 17, 2006.

* Address for reprints: Shinichiro Miyoshi, MD, PhD, Department of Cardiothoracic Surgery, Dokkyo University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan. (Email: miyoshi@dokkyomed.ac.jp).

The first 20% of the full text of this article appears below.


Figure 1
Dr Miyoshi


An extended sleeve lobectomy is rarely attempted to avoid a pneumonectomy for patients with primary lung cancer.1Go This atypical bronchoplasty procedure is technically demanding because there is a large size discrepancy between the 2 bronchial stumps. Herein we report successful implementation of an extended sleeve lobectomy with a telescoping anastomosis.

Clinical Summary

A 76-year-old man was referred to our hospital for additional investigation of an abnormal shadow on chest roentgenographic images obtained during a screening examination. A computed tomographic scan demonstrated a large mass shadow, 4 x 5 cm in size, that originated in the posterior segment of the right upper lobe (S2; Figure 1, A and B). Flexible fiberoptic bronchoscopy revealed a tumor that had completely occluded the posterior segmental bronchus of the right upper lobe (B2). A biopsy specimen was diagnosed as squamous cell carcinoma of the lung. Magnetic resonance imaging of the brain, computed tomographic scanning of the abdomen, and a bone scintigram demonstrated no evidence of distant metastases. Thus his clinical stage was classified as T2 N0 M0, stage IB disease.


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  		Figure 1. Appearance of tumor on computed tomographic scan and operative findings. A and B, Computed tomographic images show a large mass shadow, 4 x 5 cm in size, in the . . . [Full Text of this Article]

 



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