J.Jpn. Surg. Soc.. 117(4): 289-295, 2016

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Feature topic

ANGIOPLASTY TO AVOID PNEUMONECTOMY FOR THE TREATMENT OF LUNG CANCER

Plastic procedures for intrathoracic vessels are required for the preservation of pulmonary parenchyma. “Pneumonectomy itself is a disease” is one of the most famous concepts in thoracic oncology, and the preservation of lung function is obviously important. However, recent cases of lung cancer seen are generally small-sized early lesions, and the opportunity for performing such complex procedures is rare for modern thoracic surgeons. Thus the aim of this paper is to explain the importance of the procedures in detail, especially pulmonary arterioplasty. Plastic procedures of the pulmonary artery are most commonly required for left upper lobectomy for the treatment of lung cancer, due to the anatomic relations between the bronchial structure and pulmonary artery. The pulmonary artery is much longer than the bronchus, resulting in easy resection and reconstruction of the vessels. The types of reconstruction are direct running sutures, pericardial patch, and end-to-end anastomosis. Additionally, the pericardial conduit or pulmonary vein conduit has recently been reported to be useful in plastic procedures of the pulmonary artery. The details are discussed.

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