Endoscopic Findings of Post-wedge Bronchoplastic Lobectomy

It is speculated that the advantage of wedge bronchoplastic lobectomy lies in the reduction in the incidence of major anastomotic complications. On the other hand, wedge bronchoscopic lobectomy can result in kinking at the anastomosis site. This study was performed to evaluate the operative outcomes and the postoperative endoscopic findings for wedge resection of the bronchus. From 2004 to 2012, nine patients underwent wedge bronchoplastic lobectomy for lung carcinoma. We evaluated the angles of the wedge and the distance of the preserved parts to the cut line of the bronchus (the so-called bronchial bridge). There were six right upper lobectomies, two middle and lower lobectomies, and one left lower lobectomy. Regarding bronchoscopic findings, five patients who underwent right upper lobectomy showed bulging into the bronchial lumen. There were no anastomotic strictures. Intraoperatively it was noted in these five patients that the bronchial bridge tended to be relatively long and/or the angle of the wedge resection tended to be relatively wide. To prevent bulging into the bronchial lumen after right upper wedge bronchoplastic lobectomy, bronchial wedge excisions should be shaped in order to reduce the length of the bronchial bridge.