Name of the Procedure:

Resection and repair of a portion of the bronchus (bronchoplasty) when performed at the time of lobectomy or segmentectomy

Summary

This procedure involves the surgical removal and repair of a part of the bronchus (one of the major airways into the lungs) in conjunction with a lobectomy (removal of an entire lobe of the lung) or segmentectomy (removal of a segment of the lung). It is typically performed to treat or remove diseased lung tissue while maintaining as much healthy lung function as possible.

Purpose

The procedure addresses conditions affecting the lung and bronchial tubes such as lung cancer, tumors, or severe infections. The goal is to remove the diseased tissue while preserving the healthy portions of the lung to maintain optimal respiratory function.

Indications

• Lung cancer or tumors involving the bronchus
• Severe bronchial stenosis (narrowing) due to scarring or infection
• Recurrent infections or inflammations in the lung segment
• Abscesses or bronchiectasis

Typically, patients who are candidates for this procedure have been evaluated and found to have localized disease in the lung that necessitates surgery.

Preparation

• Patients may be required to fast for a specified period before the surgery.
• Adjustments to certain medications, particularly blood thinners, may be necessary.
• Diagnostic tests such as imaging (CT scans), pulmonary function tests, and a thorough medical evaluation will be conducted to assess the lung's condition.
• Preoperative consultation with the surgical and anesthesia team.

Procedure Description

1. The patient is put under general anesthesia.
2. A thoracic surgeon makes an incision in the chest (thoracotomy) to access the lung.
3. The affected lobe or lung segment is carefully removed.
4. The surgeon identifies and resects the diseased part of the bronchus.
5. The remaining healthy bronchus is then repaired (bronchoplasty) to ensure it can function properly and maintain adequate airflow.
6. The incision is closed with sutures or staples, and a chest drain may be placed to remove excess fluids.
7. The patient is taken to a recovery area for monitoring.

Duration

The procedure typically takes several hours, depending on the complexity and extent of the surgery.

Setting

The procedure is performed in a hospital setting, particularly in an operating room equipped for thoracic surgery.

Personnel

• Thoracic surgeon
• Anesthesiologist
• Surgical nurses
• Respiratory therapist
• Operating room technicians

Risks and Complications

• Bleeding
• Infection
• Difficulty breathing
• Bronchopleural fistula (abnormal connection between the bronchus and pleural cavity)
• Air leaks
• Postoperative pneumonia
• Complications related to anesthesia

Benefits

• Removal of diseased or cancerous tissue
• Preservation of healthy lung tissue
• Potentially improved breathing and lung function
• Decreased symptoms like coughing, infections, and hemoptysis (coughing up blood)

Benefits are typically realized shortly after recovery from surgery, with continued improvement over time.

Recovery

• Patients may need to stay in the hospital for several days post-surgery for observation and recovery.
• Pain management will be provided to ensure comfort.
• Breathing exercises and physical therapy may be recommended to aid recovery.
• Instructions on care for surgical wounds, activity restrictions, and follow-up appointments.
• Full recovery can take several weeks to a few months, depending on personal health and the extent of surgery.

Alternatives

• Non-surgical treatments such as radiation or chemotherapy, depending on the nature and stage of the disease.
• Less invasive surgical options if applicable, like video-assisted thoracoscopic surgery (VATS).
• Advantages of bronchoplasty include more conservative removal of lung tissue, while alternatives might involve less immediate recovery time but can be less definitive in terms of disease control.

Patient Experience

Patients can expect to experience some discomfort and pain during the initial recovery period, which will be managed with pain medications. They may have a drainage tube in place for a short period and will need to perform breathing exercises to aid lung recovery. Gradually, activities are resumed based on medical advice, with follow-up appointments to monitor healing and lung function.