PT  - JOURNAL ARTICLE
AU  - Bobocea, Andrei Cristian
AU  - Paleru, Cristian
AU  - Danaila, Olga
AU  - Istrate, Adrian
AU  - Cordos, Ioan
TI  - Five consecutive cases of left bronchial transcervical video mediastinoscopic closure
DP  - 2011 Sep 01
TA  - European Respiratory Journal
PG  - p2429
VI  - 38
IP  - Suppl 55
4099  - https://publications.ersnet.org//content/38/Suppl_55/p2429.short
4100  - https://publications.ersnet.org//content/38/Suppl_55/p2429.full
SO  - Eur Respir J2011 Sep 01; 38
AB  - Objective: The author reports the longest series of left bronchial transcervical closure using video-assisted mediastinoscopy, describing his experience with this technique and the particularities of the cases. Left bronchial closure as the first procedure of a two-step pneumonectomy for TB compromised lung is a rarely used technique.Case report: Five patients, mean age of 41.5 years, two females, three males, underwent videomediastinoscopic closure of the left main bronchi in the last 14 months, two for postpneumonectomy bronchopleural fistulas and three prior to pneumonectomy in TB destructed lung. The recovery was uneventful in every case, with the patients discharged the following day. The mean operative time was 55 min. No other incidents or procedure related complications were encountered. The three pneumonectomies followed at 3-4 weeks after the bronchial closure.Discussions: The mediastinoscopic bronchial closure is a novel option in highly selected patients. The positive factor influencing our decision were the virgin mediastinum. The dissection of the trachea through its natural route enables tracheal mobilization. It warrants minimal surgical trauma, and, if necessary, the bronchial stump has enough time to heal before the difficult pneumonectomy.Conclusions: Video-mediastinoscopy is an alternative to the open methods as it allows approaching the left main bronchi via the mediastinum. This technique is our choice because its specific morbidity is minimal compared with transpericardial sternotomy or a transthoracic approach. The mediastinoscopic approach is a novel option in highly selected patients in order to prepare and simplify a pneumonectomy.