Abstract
Median sternotomy is frequently selected for the resection of pulmonary artery tumor, and pneumonectomy is performed for complete resection. However, it is difficult to see the inferior pulmonary vein and transect it safely via median sternotomy, so additional thoracotomy is often required and this is highly invasive. In the present case, we employed thoracoscopy (which we routinely use for VATS lobectomy) to transect the inferior pulmonary vein via median sternotomy without additional intercostal thoracotomy. This method has advantages for patients undergoing pneumonectomy via median sternotomy.
Highlights
A right hilar tumor that completely occluded the right pulmonary artery was safely resected by pneumonectomy via median sternotomy with one-port thoracoscopic support
When surgery is performed via median sternotomy, additional intercostal thoracotomy is often needed to view the inferior pulmonary vein, resulting in a more invasive procedure
The pathological diagnosis was pulmonary artery sarcoma, and the patient was discharged on postoperative day 16 after an uneventful course
Summary
A right hilar tumor that completely occluded the right pulmonary artery was safely resected by pneumonectomy via median sternotomy with one-port thoracoscopic support. When surgery is performed via median sternotomy, additional intercostal thoracotomy is often needed to view the inferior pulmonary vein, resulting in a more invasive procedure. In this patient, a single thoracoscopic port allowed easy visualization of the inferior pulmonary vein and it was resected safely. We used a single thoracoscopic port (11.5 mm in diameter) placed at the 8th intercostal space on the midaxillary line in the present patient This allowed us to detect the inferior pulmonary vein and we transected it safely with a surgical stapler, while avoiding additional intercostal thoracotomy and accomplishing tight pneumonectomy. The ipsilateral pulmonary nodules were suspected to be metastatic lesions but were found to be thrombosis, and there was no evidence of malignancy
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