How different surgical methods of performing right upper lobectomy contribute to postoperative bronchial branching deformity: An experimental study

It has been suggested that postoperative bronchial deformity is a complicat ion of surgery and that the surgical methods employed may play a role in it s development. We studied the relationship between postoperative bronchial branching deformity and various surgical methods, including hand suturing o r mechanical stapling of right upper (RU) lobectomy, versus wedge or sleeve bronchoplasty with RU lobectomy. We used an in situ bronchial casting mode l in rabbits and measured the branching angles between: the trachea and the right main bronchus (RR IB); the trachea and the left main bronchus; the R MB and the intermediate bronchus (IB); the IB and the right middle lobe bro nchus (RMLB); and the RMLB and the coronal plane. In the mechanical staplin g group, the angle between the RMB and the IB was wider than in the hand su turing group, and the RMLB diverged more laterally. In the wedge plasty gro up, the angle between the trachea and the RMB was wider, while that between the IB and the RMLB was narrower than in the hand suturing group. In the s leeve plasty group, the angle between the RMB and the IB and that between t he IB and the RMLB were wider than in the hand suturing group. The findings of this experiment clearly demonstrate that postoperative deformity of the distal bronchus varies according to the surgical methods used.