Video-assisted thoracoscopic left upper lobe sleeve lobectomy combined with pulmonary arterioplasty via two-port approach

Locally advanced lung cancer, even with major artery involvement, has been adapted for thoracoscopic lung resection and obtained worldwide acceptance (1). In some patients, a resection and reconstruction of the pulmonary artery has been increasingly accepted as an alternative to total pneumonectomy as being less invasive. This technique allows patients to preserve more pulmonary function similar to the effect of bronchial sleeve lobectomy. However, vascular arterioplasty is considered a contraindication for the video-assisted thoracoscopy surgery (VATS) approach, even for experienced thoracoscopic surgeons for the high operative risk. This report describes a minimally invasive technique for VATS left upper sleeve lobectomy with pulmonary arterioplasty via the two-port approach