Article Abstract

How to deal with benign hilar or interlobar lymphadenopathy during video-assisted thoracoscopic surgery lobectomy—firing the bronchus and pulmonary artery together

Authors: Chengwu Liu, Lin Ma, Qiang Pu, Hu Liao, Lunxu Liu


Background: Anatomic lung resection for lung cancer by video-assisted thoracoscopic surgery (VATS) has become popular for resectable lung cancer. However, complicated situations with hilar or interlobar lymphadenopathy were tough for surgeons.
Methods: We’d like to introduce a method of “firing the bronchus and pulmonary artery together” via a video demo demonstration for troubleshooting situations with severe inflammatory or calcified peri-arterial/peri-bronchial lymphadenopathy. The inflammatory and calcified lymph nodes surrounding the target bronchus and artery were firstly dissected via sharp dissection using scissors. There was no clearance between the right lower bronchus and artery, then we fired them together using endo-stapler. At last, the stumps were shortened and reinforced via complementary cross mattress suture.
Results: This video shows a classic three portal VATS right lower lobectomy, which was complicated with severe inflammatory and calcified lymph nodes. The operation went through smoothly. The postoperative course of the patient was uneventful.
Conclusions: If there was no clearance between the target bronchus and artery during a complicated VATS lobectomy caused by severe lymphadenopathy, firing the bronchus and pulmonary artery together was an optimal option.


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