PMC5828922_01
Flexible bronchoscopy showing the exophytic tumor occluding the left lower bronchus (
A
). Bronchial anastomosis dehiscence after left lower sleeve resection on postoperative day 10 (
B
-
C
). Endobronchial finding prior to discharge after secondary lingular sleeve resection (
D
).
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Flexible bronchoscopy revealed an exophytic tumor completely occluding the left lower lobe bronchus (LLLB) ( Fig. 1A ). The healing was classified as grade 2 according to the classification of tracheobronchial anastomoses.  On POD 10, bronchial anastomotic dehiscence at the medial wall of the anastomosis was detected during second routine bronchoscopy ( Fig. 1B , C ). Therefore, surgical revision was indicated. Flexible bronchoscopy revealed healing of the anastomosis ( Fig. 1D ) and the patient was discharged uneventfully ( Fig. 3B ).
Schematic figure of the left lower sleeve resection (
A
,
B
) and subsequent lingular sleeve resection (
C
,
D
).
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PMC5828922_01_10-1055-s-0038-1635124-i1700039cr-2.jpg
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Bronchial anastomosis between the left upper lobe and left main bronchus (LMB) was achieved by interrupted 4-0 polydioxanone sutures (PDS, Ethicon, Germany) tied at completion of the anastomosis ( Fig. 2A , B ). Bronchial anastomosis was achieved as described above ( Fig. 2C , D ).
Postoperative X-ray of the chest immediately after sleeve resection of the left lower lobe (
A
) and before discharge after the redo-sleeve resection (
B
).
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The postoperative X-ray showed a fully expanded left upper lobe ( Fig. 3A ). 