[Treatment of endoscopic laser therapy for obstruction due to granulation at the anastomosis site after right sleeve lobectomy].

A case treated with endoscopic laser therapy for obstruction due to granulation at the anastomosis site after sleeve lobectomy was reported. A 57-year-old male was admitted to our hospital with complaint of dyspnea four months after right sleeve upper lobectomy for long cancer. Chest roentgenogram showed complete atelectasis of the right lung and bronchoscopy revealed obstruction at the anastomotic site. The biopsy of the site showed granulation tissue. Pulmonary angiography immediately after bronchography yielded 3 to 4 mm obstruction in length and no particular vascular communication between the obstruction site and pulmonary vessel. Nd-YAG Laser irradiation of 774 Joules gave complete reopening. Good patency has been maintained one month since the laser therapy. It is important to recognized bronchus peripheral to the obstructive site and to identify the correlation between the anastomotic site and vascular system preoperatively. Pulmonary angiography combined with bronchography examination could be very useful to obtain these information.