Totally endoscopic lobectomy and segmentectomy for congenital bronchial atresia

Abstract

Congenital bronchial atresia is a congenital obliteration of a segmental or lobar bronchus resulting in an inflation of the correspondent parenchyma. It may lead to infectious complications and in the long-term to alteration of the adjacent lung parenchyma. As it usually occurs in young and healthy patients with normal lungs, this disorder is particularly suitable for a full endoscopic pulmonary resection. We report our recent experience of two lobectomies and one segmentectomy in three patients.

Bronchocele: Two Cases

“…The left upper lobe involvement is 64% while left lower lobe is 14% involved [9]. It is commonly demonstrated at a single segmential bronchiol, yet multiple segmential atresias are also reported [1,6].…”

“…Hyperinflation of the obstructed lung segment and check valve mechanism is held responsible [6,11]. It may be associated with congenital cystic adenomatoid malformation and pectus excavatum [9,14,15].…”

“…It generally results from a localized defect in normal bronchopulmonary embryogenesis [5,8]. The development of lungparenchyme is generally normal [9]. It has a male predominance.…”

Bronchial Atresia

“…They describe the finger-in-glove sign, a radiographic feature that refers to mucoid impaction in central airways.  Some surgeons like Cappeliez et al (2009) or Zribi et al (2011 think that bronchial atresia may lead to infectious complications and, in the long term, to damage to the adjacent lung parenchyma. Therefore, a surgical resection may be necessary.…”

Lung Diseases - Selected State of the Art Reviews

“…They describe the finger-in-glove sign, a radiographic feature that refers to mucoid impaction in central airways.  Some surgeons like Cappeliez et al (2009) or Zribi et al (2011) think that bronchial atresia may lead to infectious complications and, in the long term, to damage to the adjacent lung parenchyma. Therefore, a surgical resection may be necessary.…”