Is “en masse” lobectomy feasible in the recent era?

Excerpt

Kamiyoshihara et al. reported twelve cases of “en masse” lobectomy using VATS technique in this Journal (GTCS). Simultaneous ligation or stapling of hilum configuring by pulmonary vessels and bronchi is not a new technique, but old. This technique is also called “en masse” or tourniquet lobectomy. Gluck reported pulmonary resection by “en masse” ligation technique in animal models [1], and Babcock showed the anatomical lung resection by individual hilar ligation technique in 1908 [2]. Since Blades and Kent reported the isolation-ligation technique in American Association for Thoracic Surgery annual meeting [3], individual ligations of vessels and bronchi were accepted for standard procedure of lobectomy and declined “en masse” lobectomy. Historically, Gaskin et al. [4] reported pneumonectomy by “en masse” stapling of hilar vessels in 1975. Furthermore, Lewis et al. [5] showed the simultaneously stapled lobectomy by video-assisted thoracic surgery (VATS) and no complications related to this technique. However, these “en masse” lobectomy were not widespread because surgeons assumed high incidence of bronchopleural fistulas (BPF) regardless of lack of apparent evidence. …