Is “en masse” lobectomy feasible in the recent era?

Gluck reported pulmonary resection by “en masse” ligation technique in animal models [1], and Babcock showed the anatomical lung resection by individual hilar ligation technique in 1908 [2]. Since Blades and Kent reported the isolation-ligation technique in American Association for Thoracic Surgery annual meeting [3], individual ligations of vessels and bronchi were accepted for standard procedure of lobectomy and declined “en masse” lobectomy. [...]infected disease of the lung remains still a risk factor of BPF in spite of the low incidences compared with the previous results. Since infected bronchi, such as chronic bronchitis, were closed with pulmonary vessels by this technique, the risk of BPF may be increased compared to the individual ligation technique. [...]the limitations of this report were relative short follow-up periods and bias of patients selection which consisted of only ten patients of N1 and 4 of N2. [...]it should not be concluded that this technique can secure the oncological effect and may be premature.