Deeper wedge resection and parenchymal-sparing bronchoplasty of the secondary carina: an alternative surgical technique for removal of tumor located at the orifice of upper lobar bronchus

BACKGROUND: Sleeve resection and reconstruction of the bronchial corner between the upper lobar bronchus and the intermediate bronchus is technique demanding. CASE PRESENTATION: A 33-year-old Chinese man suffered from recurrence of low-grade malignant mucoepidermoid carcinoma located at the orifice of upper lobar bronchus with invasion to the main bronchus nearly 1 year after he had undergone an incomplete bronchoscopic resection. With detailed preoperative and intraoperative evaluation by computed tomography and bronchoscopy, a deeper wedge resection and bronchoplasty of the secondary carina was performed. The freedom from tumor cells at the cut-edges was guaranteed by frozen examination. The postoperative course was uneventful and the patient was free from recurrence for 18 months after the surgery. CONCLUSIONS: With an R0 resection, the procedure described in the present case report was feasible and relatively easy, thus an alternative to sleeve lobectomy or sleeve bronchial resection for small-size low-grade malignancy located at the orifice of upper lobar bronchus.