Video-assisted thoracic surgery lobectomy with bronchoplasty for lung cancer: Initial experience and techniques

Background. Many surgeons think video-assisted thoracic surgery is too complex to be applied to bronchoplasty; therefore, our institution tried to develop some safe and reliable techniques for video-assisted thoracic surgery bronchoplasty. Methods. One hundred thirty-four patients with lung cancer underwent curative video-assisted thoracic surgery lobectomy including mediastinal dissection at Iizuka hospital between October 2001 and September 2006. Five of these patients underwent radical lung lobectomy with bronchoplasty using video-assisted thoracic surgery. A minithoracotomy was performed at the lateral chest wall to place sutures around the bronchi. A continuous suture was placed at the median wall of the bronchi in cases of circumferential reconstruction, and shortened rubber tubes and silk suture lines were used for assisting with reconstruction. Results. One patient with right lung carcinoma was treated with sleeve resection of the right main bronchus, whereas the others were treated with wedge resection. In one case, chylothorax was seen as a postoperative complication. There were no serious complications related to bronchoplasty. All cases are alive without any recurrence during follow-up. Conclusions. The importance of position of minithoracotomy and another access port, management of sutures, and the secure tightened method was assessed. There were no serious postoperative complications. Video-assisted thoracic surgery bronchoplasty is a complex procedure, but it can safely be performed using some additional techniques.