Endobronchial ultrasound-facilitated video-assisted lobectomy with wedge bronchoplasty for typical carcinoid tumor of the right middle lobe.

Abstract

A 19-year-old man presented with pneumonia, cough, and occasional dyspnea. Chest CT scan and bronchoscopy with biopsy revealed a typical carcinoid tumor obstructing the orifice of the right middle lobe, leading to lobar collapse. Preoperative surgical planning included radial endobronchial ultrasound, which confirmed that the tumor was not invasive into the bronchus intermedius. With that information, a video-assisted right middle lobectomy was performed with a wedge bronchoplasty in order to preserve the right lower lobe. The operation was performed completely thoracoscopically with three 1.2-cm ports and one 3.5-cm utility incision. With the intralobar pulmonary artery retracted, the bronchus was divided with a scalpel in wedge fashion to obtain a margin on the endobronchial tumor, and the defect was closed with absorbable suture. The patient recovered without complication and was doing well at 8-month follow-up, without evidence of recurrent disease.