A successful case of right upper and middle sleeve lobectomy for right lung cancer with inflammatory stenosis of the middle bronchus

• Published in: The Journal of the Japanese Association for Chest Surgery Vol. 29; no. 4; pp. 491 - 494
• Main Authors: Iwata, Teruo, Takenaka, Masaru, Oka, Souichi, Sou, Tomoko, Uramoto, Hidetaka, Tanaka, Fumihiro
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Association for Chest Surgery 15.05.2015
• Subjects: inflammatory bronchial stenosis; lung cancer; small cell lung cancer; upper and middle sleeve lobectomy
• ISSN: 0919-0945; 1881-4158
• DOI: 10.2995/jacsurg.29.491

We report a resected case of advanced right lung cancer invading the entrance of the right upper bronchus, with inflammatory stenosis of the middle bronchus in a 74-year-old man. We performed right upper and middle sleeve lobectomy. Computed tomography revealed a mass of 52×37 mm invading the ascending pulmonary artery. Transbronchial lung biopsy was performed, but a preoperative diagnosis was not obtained. A bronchofiber could not be passed through the middle bronchus because of the severe inflammatory stenosis. The preoperative diagnosis was lung cancer, and the clinical stage was T2bN0M0, IIA. We performed right upper and middle sleeve lobectomy and combined resection of the azygos arch. We anastomosed the right main bronchus and peripheral part of the intermedius, and then covered it with a pedicled pericardial fat pad. We resected the pulmonary ligament to reduce the tension of anastomosis. The pathological diagnosis was small cell lung cancer, and the final stage was T3N1M0, IIIA. Four courses of adjuvant chemotherapy (CDDP/CPT-11) were administered. No recurrence has occurred to date.