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How To Do It

Bronchial Flap Closure of the Right Lower Lobe Bronchus

^a Department of Cardiothoracic Surgery, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
^b Division of Thoracic Surgery, Toronto General Hospital, Toronto, Ontario, Canada

Accepted for publication January 22, 2009.

^_* Address correspondence to Dr West, Division of Thoracic Surgery, Toronto General Hospital, 200 Elizabeth St, Toronto, Ontario, M5G 2C4, Canada (Email: dgwest{at}rcsed.ac.uk).

We describe a novel method for closure of the bronchus intermedius, after right lower lobectomy, using a flap derived from the lower lobe apical segmental bronchus. We have successfully used this technique in an endobronchial carcinoid tumor occurring in a young man. It allowed middle lobe preservation despite a very proximal tumor position within the basal trunk bronchus. Adequate tumor margins were confirmed by on-table frozen section examination. This technique may have particular use in carcinoids or benign tumors.