Right pneumonectomy with carinal wedge resection

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  • Sugai Kazuto
    Department of General Thoracic Surgery, Tsukuba University Hospital
  • Goto Yukinobu
    Department of General Thoracic Surgery, Tsukuba University Hospital
  • Kobayashi Naohiro
    Department of General Thoracic Surgery, Tsukuba University Hospital
  • Kikuchi Shinji
    Department of General Thoracic Surgery, Tsukuba University Hospital
  • Sato Yukio
    Department of General Thoracic Surgery, Tsukuba University Hospital

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  • 気管wedge resectionによる右肺全摘

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Abstract

<p>A 75-year-old man presented with bloody sputum. Chest computed tomography (CT) showed a tumor shadow in the superior segment of the right lung, which occluded the inferior lobar bronchus and infiltrated the center of the right main bronchus. Bronchoscopic biopsy results confirmed the diagnosis of a poorly differentiated lung adenocarcinoma (cT3N1M0, Stage IIIA). Right pneumonectomy was performed with curative intent. Stapling of the right main bronchus using an automatic suture instrument at a point 1 bronchial cartilage ring peripheral to the tracheal bifurcation was attempted. However, intraoperative air leakage from the staple line was identified, due to excessive tension of the suture applied to the bronchial stump.</p><p>Therefore, after a second resection of the stump, additional wedge resection of the trachea was performed. This led to the natural alignment of the bronchial and tracheal stump, Facilitating easy anastomosis, without requiring operative field intubation.</p>

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