Uniportal video-assisted thoracic surgery lobectomy in a patient with carcinoid tumor located at the orifice of the right lower lobe

We present here a 47-year old male patient who had a typical carcinoid tumor located at the orifice of right lower lobe bronchus underwent uniportal thoracoscopic lower lobectomy following bronchoscopic removal of the endobronchial tumor. Tumor was seen by bronchoscopy to protrude out from the lower lobe into the intermediary bronchus obstructing the lower lobe completely and the middle lob partially. However, the origin of the endobronchial tumor was in the distal part of the lower lobe bronchus. In this case, open surgery could be an alternative to save the middle lobe by incising the lower lobe bronchus to pull out the endobronchial tumor first during thoracotomy. The other alternative could be a thoracoscopic lower bilobectomy for achieving a curative resection. In this patient, we performed sequential approaches at the same session as; bronchoscopic removal of the endobronchial tumor first, and then uniportal VATS lower lobectomy. Frozen section pathological analyses of bronchial stump of resected right lower lobe as well as the postoperative bronchoscopic biopsy confirmed a tumor-free margin. Patient was discharged on postoperative day four after an uneventful postoperative course.