Delayed Bronchial Perforation Caused by Soft Coagulation after Right Lower Lobectomy

DOI 1 Citations Open Access
  • Takagi Hironori
    Department of Chest Surgery, Fukushima Medical University School of Medicine Department of Chest Surgery, Iwaki City Medical Center
  • Muto Satoshi
    Department of Chest Surgery, Fukushima Medical University School of Medicine
  • Fukuhara Mitsuro
    Department of Chest Surgery, Iwaki City Medical Center
  • Inomata Sho
    Department of Chest Surgery, Fukushima Medical University School of Medicine
  • Yamaguchi Hikaru
    Department of Chest Surgery, Fukushima Medical University School of Medicine
  • Watanabe Masayuki
    Department of Chest Surgery, Fukushima Medical University School of Medicine
  • Ozaki Yuki
    Department of Chest Surgery, Fukushima Medical University School of Medicine
  • Okabe Naoyuki
    Department of Chest Surgery, Fukushima Medical University School of Medicine
  • Matsumura Yuki
    Department of Chest Surgery, Fukushima Medical University School of Medicine
  • Shio Yutaka
    Department of Chest Surgery, Fukushima Medical University School of Medicine
  • Suzuki Hiroyuki
    Department of Chest Surgery, Fukushima Medical University School of Medicine

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  • 術中に使用したソフト凝固が原因と考えられた遅発性の気管支穿孔の1例

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Abstract

<p>Background. A few reports have described postoperative bronchopleural fistulae or bronchial perforations other than bronchopleural fistula with a bronchial stump, but some reports have described such fistulae occurring from damage to the tissues of the trachea and bronchi due to the use of energy devices. Case. A 61-year-old woman received a preoperative diagnosis of right lower lobe lung adenocarcinoma. During thoracoscopic right lower lobectomy, bleeding occurred from the bronchial artery around the intermediate bronchus, and soft coagulation was performed using ball electrode coagulation. About 5 weeks after the first operation, the patient developed a fever, and bronchoscopy revealed perforation of the middle bronchial trunk, probably caused by thermal damage from soft coagulation. Since closing the fistula was difficult, open-window thoracostomy was performed. The fistula closed spontaneously with daily wound care. Conclusion. Soft coagulation is an effective technique for hemostasis and repair of air leaks, but it can cause thermal damage and should be used with a proper understanding of the characteristics of both the device and bronchial anatomy.</p>

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