Abstract
Right upper sleeve lobectomy is the modality of choice for lung cancer invading to the orifice of the right upper bronchus. A case of bronchoplasty for lung cancer is reported. Anastomosis was conducted between the tracheal wall and the truncus intermediate bronchus, because of the anomalous bronchus (B^1) arising from the tracheal wall. A 46-year-old male suffered from dry cough and sputum and he consulted another hospital in March 1997. An abnormal shadow on his chest X-ray film was pointed out and he was admitted for further examination and proper treatment in April 1997. The chest X-ray showed an ill-defined mass shadow in the right hilum, 5.0×4.0 cm in size. The chest CT revealed a nonhomogeneous tumor which obstructed the orifice of the right upper bronchus (B^<2+3>). An anomalous bronchus (B^1) arising from the tracheal wall was also detected. Bronchofiberscopy revealed an abnormal orifice (B^1) on the right side of the trachea. The orifice of B^<2+3> was obstructed by the polypoid tumor, and the biopsy specimens revealed squamous cell carcinoma. Pulmonary angiography showed A^1 arising from the right trunk, wedge-shaped obstruction of the truncus superior artery (A^<2+3>) and encasement of the ascending artery (A^2b). Right upper sleeve lobectomy and mediastinal node dissection were conducted. The anastomotic sites were the right tracheal wall proximally and the truncus intermedius distally. Angioplasty with Gore-tex patch was done after a partial resection of the pulmonary artery. The postoperative stage was p-T3N2M0, stage IIIA.
