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Japanese

Successful Treatment by Performing a Middle Lobectomy for a Postoperative Bronchus Intermedius Membrane Perforation After Right Lower Lobectomy Yasuyuki Nakamura 1 , Eiji Yatsuyanagi 1 1Department of General Thoracic Surgery, Obihiro Hospital Keyword: lung cancer , postoperative complication , bronchial perforation , bronchus intermedius pp.643-648
Published Date 2024/9/1
DOI https://doi.org/10.15106/j_kyobu77_643
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We report a case of postoperative perforation in the bronchus intermedius membrane after pulmonary resection for lung cancer. An 83-year-old man with lung cancer underwent thoracoscopic right lower lobectomy+ND2a-1 dissection. On postoperative day 11, subcutaneous emphysema appeared to him, and chest radiograph showed niveau formation and pleural effusion on the operative side. Chest computed tomography (CT) suggested a bronchial membrane defect of the bronchus intermedius. We confirmed a bronchial perforation in the bronchus intermedius membrane by bronchoscopy and performed urgent operation. The defect of the perforated membrane was too large to be sutured directly, so a middle lobectomy was performed. After this operation, the patient had a small bronchial stump fistula which was successfully treated with endoscopic bronchial occlusion. Although the patient required treatment for heart failure, he recovered and was discharged 44 days after the reoperation. This perforation could be caused not only by bronchial ischemia due to subcarinal lymph node dissection, but also by injury to the adventitia of the bronchus intermedius membrane due to rough handling and unrecognized burning of the injured area with an electric scalpel. Thermal damage caused by energy devices needs to be noted.


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電子版ISSN 2432-9436 印刷版ISSN 0021-5252 南江堂

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