Do Japanese thoracic surgeons think that dissection of the pulmonary ligament is necessary after an upper lobectomy?

It is uncertain whether the dissection of the pulmonary ligament is necessary in patients who undergo an upper lobectomy. A questionnaire was sent to the directors of Thoracic Surgery in 102 hospitals, asking whether dissection of the pulmonary ligament is performed in such patients, and the complic...

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Bibliographic Details
Published in:Surgery today (Tokyo, Japan) Japan), 2010-11, Vol.40 (11), p.1097-1099
Main Authors: Usuda, Katsuo, Sagawa, Motoyasu, Aikawa, Hirokazu, Tanaka, Makoto, Machida, Yuichiro, Ueno, Masakatsu, Sakuma, Tsutomu
Format: Article
Language:English
Subjects:
Humans
Japan
Ligaments - surgery
Lung Neoplasms - surgery
Medicine
Medicine & Public Health
Pneumonectomy - methods
Postoperative Complications - etiology
Postoperative Complications - prevention & control
Short Communication
Surgery
Surgical Oncology
Surveys and Questionnaires
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Summary:It is uncertain whether the dissection of the pulmonary ligament is necessary in patients who undergo an upper lobectomy. A questionnaire was sent to the directors of Thoracic Surgery in 102 hospitals, asking whether dissection of the pulmonary ligament is performed in such patients, and the complications associated with dissecting or preserving the ligament. Seventy-eight directors (76%) returned the questionnaire. The preservation of the ligament is the current practice in 54 hospitals (69%), while 13 hospitals (17%) occasionally dissect, 9 hospitals (11%) regularly dissect, and 2 hospitals (3%) half dissect the ligament. Thirty directors experienced complications which were thought to be associated with dissecting the ligament: bronchial stenosis (21 directors), atelectasis (8), and bronchial obstruction (4). Twenty-six directors described complications thought to be associated with preserving the ligament: the pooling of pleural effusion (19 directors), insufficient expansion of lung (18), atelectasis (8), and empyema (7). Preservation of the ligament may therefore be useful in preventing bronchial stenosis and obstruction, while its dissection may be useful to prevent the pooling of pleural effusion.
ISSN:0941-1291
1436-2813
DOI:10.1007/s00595-009-4173-8