Hybrid bilobectomy for treatment of an early-stage lung cancer in a patient with severe emphysema using the benefits of lung volume reduction.
Eur J Cardiothorac Surg
; 52(5): 1000-1002, 2017 Nov 01.
Article
em En
| MEDLINE
| ID: mdl-28977365
ABSTRACT
Patients with resectable lung cancer and concomitant emphysema can fall outside the accepted guidelines for surgery. Lung volume reduction can improve their lung function but involves resecting an emphysematous lobe containing the tumour. Volume reduction can also be achieved by endobronchial one-way valve insertion, causing lobar collapse, but intact fissures are required. A 'hybrid bilobectomy' was performed on a 77-year-old ex-smoker with suspected T2aN0M0 bronchogenic carcinoma and severe pulmonary emphysema. The procedure consisted of endobronchial right lower lobe volume reduction and video-assisted middle lobectomy with stapled completion of the oblique fissure. Complete collapse of the right lower lobe was confirmed intraoperatively and on follow-up chest films. The recovery period was complicated by a prolonged air leak. We believe that concomitant endobronchial volume reduction of an ipsilateral lobe can facilitate video-assisted lobectomy in high-risk patients with severe emphysema. The success of endobronchial valves to achieve a hybrid bilobectomy is increased by stapled completion of fissure to prevent collateral ventilation.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pneumonectomia
/
Enfisema Pulmonar
/
Neoplasias Pulmonares
Limite:
Aged
/
Humans
/
Male
Idioma:
En
Revista:
Eur J Cardiothorac Surg
Assunto da revista:
CARDIOLOGIA
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Reino Unido