1994 Volume 8 Issue 2 Pages 185-189
We have tried a new technique to cover the bronchoplastic anastomotic site by the latissimus dorsi muscle at the same thoracotomy site.
In thoracotomy, cutting of the latissimus dorsi muscle should be avoided because this muscle is very long and is useful to cover the bronchopleural fistula or defect of the chest wall. Recently we have performed this muscle sparing thoracotomy and inserted the spared latis-simus dorsi muscle by way of the third intercostal space to the anastomotic site of wedge bronchoplasty.
At first, we perform sleeve or wegde resection of a right or left upper lobe from the main bronchus. After anastomosing the bronchus, a few sutures should be placed at the anastomotic site fixing the latissimus dorsi muscle. A part of the latissimus dorsi muscle (about 5cm) should be taken from the distal site without injuring the thoracodornal artery, which is very important for the blood supply of this muscle. This latissimus dorsi muscle should be fixed to the bronchoplastic anastomotic site with the previously placed sutures.
We applied this method in 3 lung cancer patients. All patients had been shown to have tumors in the right upper orifice by preoperative bronchoscopy. One case was stage I (T2N0M0), while the other cases were stage III (T3N1M0 and T2N2M0). The postoperative courses were uneventful and one case received radiotherapy four weeks after operation.
In conclusion, this technique to cover the anastomotic site of the bronchoplasty is very simple and easy for patients receiving adjuvant therapy, and is not accompanied by the complication of postoperative bronchopleural fistula.
