Technique and Application of Bronchoplasty in Thoracoscopic Surgery

Tatsuo Nakagawa, Yasuaki Tomioka, Toshiya Toyazaki

Tenri Hospital, Tenri, Japan

Date, time and location: 2018.05.26 13:30, Congress Hall, 2F–C

Abstract

【Objective】Bronchoplasty is considered to be performed when the orifice of the lobar bronchus is involved with tumor. Open thoracotomy is usually performed if tumor invades to main pulmonary artery. On the other hand, bronchoplasty under thoracoscopic view is challenging but achievable if tumor is localized without vessel invasion. We have performed VATS bronchoplasty for lung cancer since 2012 and hereby present our clinical experiences of VATS bronchoplasty.【Method】The procedure was basically performed in 2 ports plus utility window or 4 ports fashion using complete thoracoscopic technique. Bronchial anastomosis was performed using a continuous suture and recently a absorbable barbed suture (V-Loc™) has been applied for bronchoplasty.【Results】We experienced seven cases of VATS bronchoplasty including three cases of right upper sleeve lobectomy, one case of right lower sleeve lobectomy and three cases of deep wedge resection of right upper and middle bronchus. Pathology was squamous cell carcinoma for four patients, adenocarcinoma for two patients and metastatic carcinoma for one patient. Two cases needed small thoracotomy due to bleeding of pulmonary artery for one and minor leakage form anastomosis for the other. All the patients experienced no problems with the bronchial anastomosis during the follow-up period. Suturing using a barbed suture was simpler and more effective than the conventional technique because it was able to distribute tension across the wound without the need to tie knots.【Conclusions】VATS bronchoplasty is achievable with safe and secure technique to limited patients with lung cancer.