A case of B⁶ bronchial flap reconstruction for patient with low-grade mucoepidermoid carcinoma

Abstract

In patients undergoing surgery for primary lung cancer in Japan, the proportion of those receiving bronchoplasty is reportedly 1.7%. In this article, we report a relatively rare technique, flap bronchoplasty. The patient was an 11-year-old girl. A tumorous lesion was detected on investigating repeated pneumonia, occupying the bronchus intermedius. Initially, a diagnosis of benign papilloma was made based on bronchoscopy-guided biopsy findings. Rigid bronchoscope-guided core-out tumorectomy was performed. Finally, pathological findings suggested a low-grade mucoepidermoid carcinoma. Bronchoscopy revealed residual tumor cells at the tumor base on the B⁶ side of the bifurcation between the B⁶ area and bronchus basalis. Based on these findings, additional resection was considered necessary. S⁶ segmentectomy with wedge resection of the bifurcation between the B⁶ area and bronchus basalis was performed. Reconstruction with a B⁶ bronchial flap for an inferior-lobe bronchial defect was conducted. Due to ①the tumor base being located on the bifurcation between the B⁶ area and bronchus basalis, and ②preopearative pathological findings suggesting a low-grade mucoepidermoid carcinoma, reconstruction with a B⁶ bronchial flap (S⁶ segmentectomy) was performed as limited surgery.