naa a22 4500 51072860X CHVBK 20180411082944.0 cr unu---uuuuu 180411e20130501xx s 000 0 eng 10.1007/s11748-012-0159-3 doi (NATIONALLICENCE)springer-10.1007/s11748-012-0159-3 Pulmonary lobar root clamping and stapling technique: return of the "en masse lobectomy” [Elektronische Daten] [Mitsuhiro Kamiyoshihara, Hitoshi Igai, Takashi Ibe, Yoichi Ohtaki, Jun Atsumi, Seshiru Nakazawa, Kazumi Tanaka, Kai Obayashi, Kimihiro Shimizu, Izumi Takeyoshi] Purpose: Most thoracic surgeons have experienced difficulty dissecting the pulmonary hilus because of scarring. In such potentially dangerous situations, we advocate a method of clamping and severing the pulmonary lobar root structure en masse. The aim of this study was to evaluate en masse lobectomy, particularly considering the constellation of pulmonary vessels and the bronchus. Methods: Twelve patients (median age 70years) underwent en masse lobectomy. We retrospectively evaluated the surgical procedures and clinical outcomes. Care was taken to consider the remaining vessels and bronchus, which regulate the direction of device placement. Results: Seven patients had inflammatory lung disease, four had primary pulmonary carcinoma, and one had suffered blunt chest trauma. Ten operations were elective and two were emergent. Lobectomy included the right upper lobe in two cases, the right middle lobe in three, the right lower lobe in two, the right middle-lower lobe in two, and the left lower lobe in three. A stapler was used in ten patients, and sutures were applied in three (both were used in one case). Morbidities included a pyothorax and a persistent air leak; both made a recovery. Mortality included one emergency case of acute respiratory distress syndrome. No bronchopleural or bronchovascular fistulas occurred. Conclusions: We believe that the en masse lobectomy is an alternative and necessary technique in critical or unexpected situations, possibly as a last resort. Trauma and severe inflammation may be good indications for en masse lobectomy. The Japanese Association for Thoracic Surgery, 2012 En masse lobectomy nationallicence Inflammatory lung disease nationallicence Lung cancer nationallicence Chest trauma nationallicence Kamiyoshihara Mitsuhiro Department of General Thoracic Surgery, Maebashi Red Cross Hospital, 3-21-36 Asahi-Cho, 371-0014, Maebashi, Gunma, Japan aut Igai Hitoshi Department of General Thoracic Surgery, Maebashi Red Cross Hospital, 3-21-36 Asahi-Cho, 371-0014, Maebashi, Gunma, Japan aut Ibe Takashi Department of General Thoracic Surgery, Maebashi Red Cross Hospital, 3-21-36 Asahi-Cho, 371-0014, Maebashi, Gunma, Japan aut Ohtaki Yoichi Division of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan aut Atsumi Jun Division of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan aut Nakazawa Seshiru Division of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan aut Tanaka Kazumi Division of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan aut Obayashi Kai Division of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan aut Shimizu Kimihiro Division of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan aut Takeyoshi Izumi Division of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan aut General Thoracic and Cardiovascular Surgery Springer Japan 61/5(2013-05-01), 280-291 1863-6705 61:5<280 2013 61 11748 https://doi.org/10.1007/s11748-012-0159-3 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s11748-012-0159-3 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kamiyoshihara Mitsuhiro Department of General Thoracic Surgery, Maebashi Red Cross Hospital, 3-21-36 Asahi-Cho, 371-0014, Maebashi, Gunma, Japan aut NATIONALLICENCE 700 1- Igai Hitoshi Department of General Thoracic Surgery, Maebashi Red Cross Hospital, 3-21-36 Asahi-Cho, 371-0014, Maebashi, Gunma, Japan aut NATIONALLICENCE 700 1- Ibe Takashi Department of General Thoracic Surgery, Maebashi Red Cross Hospital, 3-21-36 Asahi-Cho, 371-0014, Maebashi, Gunma, Japan aut NATIONALLICENCE 700 1- Ohtaki Yoichi Division of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan aut NATIONALLICENCE 700 1- Atsumi Jun Division of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan aut NATIONALLICENCE 700 1- Nakazawa Seshiru Division of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan aut NATIONALLICENCE 700 1- Tanaka Kazumi Division of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan aut NATIONALLICENCE 700 1- Obayashi Kai Division of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan aut NATIONALLICENCE 700 1- Shimizu Kimihiro Division of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan aut NATIONALLICENCE 700 1- Takeyoshi Izumi Division of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan aut NATIONALLICENCE 773 0- General Thoracic and Cardiovascular Surgery Springer Japan 61/5(2013-05-01), 280-291 1863-6705 61:5<280 2013 61 11748 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer