Hybrid bilobectomy for treatment of an early-stage lung cancer in a patient with severe emphysema using the benefits of lung volume reduction†
Year: 2017
Type: article
Study design: Case Report
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.
DOI: 10.1093/ejcts/ezx259
Institution: Glenfield Hospital
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2736978515
