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J Thorac Cardiovasc Surg 2008;135:1184-1185
© 2008 The American Association for Thoracic Surgery

Brief Communication

Atypical bronchoplasty to preserve the lung parenchyma: The bronchofolding technique

Mitsuhiro Kamiyoshihara, MD, PhDa,*, Takashi Ibe, MDa, Atsushi Takise, MD, PhDb, Izumi Takeyoshi, MD, PhDc

a Department of General Thoracic Surgery, Maebashi Red Cross Hospital, Maebashi, Gunma, Japan
b Department of Respiratory Medicine, Maebashi Red Cross Hospital, Maebashi, Gunma, Japan
c Division of Thoracic and Visceral Organ Surgery, Gunma Graduate University School of Medicine, Maebashi, Gunma, Japan

Received for publication September 17, 2007; revisions received October 26, 2007; accepted for publication December 27, 2007.

* Address for reprints: Mitsuhiro Kamiyoshihara, MD, PhD, Department of General Thoracic Surgery, Maebashi Red Cross Hospital, 3-21-36 Asahi-Cho, Maebashi, Gunma 371-0014, Japan. (Email: micha2005jp@yahoo.co.jp).

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

Many cases involving atypical bronchoplasty have been reported.1-3Go The patient reported here presented with an elongated oval bronchial defect involving the bronchus intermedius. To preserve the lung parenchyma, we performed a wedge resection of the remaining wall between the upper and middle bronchus and anastomosed the bronchial stumps. We consider this procedure as a type of wedge or flap lobectomy, as described in Khargi and colleagues1Go; that is, the bronchial stump was anastomosed by folding the bronchial wall of the bronchus intermedius. Here we describe a successful procedure for an atypical bronchoplasty using the bronchofolding technique.

Clinical Summary

A 72-year-old man was referred to our hospital for further investigation of an abnormal shadow seen on a chest radiograph taken during a medical check-up. Computed tomographic (CT) analysis revealed the shadow of a mass, measuring 3 x 2 cm, that originated in the superior segment (S6) of the right lower lobe ( Go Figures 1, A, and 2, A). Flexible bronchoscopy showed no endobronchial tumor, but it did show stenosis of the bronchus intermedius, where it was compressed . . . [Full Text of this Article]






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