Parenchymal Preserving Bronchoplasty

Surgical resection is curative for carcinoid tumors of the airway (1). Parenchymal preserving techniques such as bronchoplasty and sleeve resections have been shown to have equivalent oncological outcomes when compared to more radical resections (2). This video demonstrates two cases. The first is a simple resection of a typical carcinoid tumor located in the right main bronchus, followed by a simple end-to-end bronchial anastomosis. In the second case, the tumor is located in the junction of the right upper lobe and bronchus intermedius, necessitating a more complex reconstruction with two separate anastomoses (bronchus intermedius to right main bronchus and right upper lobe bronchus to right main bronchus). 

To make it easier for residents and medical students to follow, wherever possible, the video illustrates the anatomy with colored annotations. 

References

1. Ferguson MK, Landreneau RJ, Hazelrigg SR, Altorki NK, Naunheim KS, Zwischenberger JB, Kent M, Yim AP. Long-term outcome after resection for bronchial carcinoid tumors. Eur J Cardiothorac Surg. 2000 Aug;18(2):156-61. doi: 10.1016/s1010-7940(00)00493-0. PMID: 10925223.
2. Deslauriers J, Gre ́goire J, Jacques LF, Piraux M, Guojin L, Lacasse Y. Sleeve lobectomy versus pneumonectomy for lung cancer: a comparative analysis of survival and sites or recurrences. Ann Thorac Surg 2004;77:1152—6.

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