The pure distal left main bronchial sleeve resection with total lung parenchymal preservation: report of two cases and literature review

Abstract

Pure bronchial sleeve resection and reconstruction is a type of rare thoracic surgery, especially for the second carina reconstruction on the left side, needs more exquisite surgical techniques, and patient selection to such surgery often requires rigorous screening. We present two cases of left main bronchial adenoid cystic carcinoma with the second carina reconstruction. The purpose of this paper is to recommend a useful supplement to conventional surgery for some very selected patients.

Keywords: Lung cancer; bronchial carcinoma; bronchoplastic resection; parenchymal-sparing surgery; pulmonary preservation; sleeve resection.

Figure 1

(A) Computed tomography scan showed the lesion located at the end of left main bronchus, between the opening of upper and lower bronchus; (B) chest radiography at the first day of postoperation showed the upper and lower lobes of left lung were both full recruitment; (C) computed tomography after 3 weeks of postoperation showed anastomotic healing well, and the opening of upper and lower lobe bronchus were smooth.

Figure 2

(A) Preoperative radiography and computed tomography show endobronchial tumor locates at the left main bronchi, the whole left lung is atelectasis, mediastinal moves to left thoracic cavity; (B) postoperative radiography showed the left lung recruit well; (C) computed tomography scan after 3 months (C₁,C₂) and 1 year (C₃,C₄) of postoperation showed anastomotic between left main bronchi and upper and lower lobe bronchial was smooth. The tumor was no recurrence sign.