The first step when doing a penumononectomy for cancer of the bronchus is to -
• Pneumonectomy is anatomically more straightforward than lobectomy (in carcinoma bronchus):
• The pulmonary artery is first dissected, divided and sutured.
• The pulmonary veins are then isolated, divided and sutured.
• The main bronchus is divided so that no blind stump remains. The technique of stump closure is important if a bronchopleural fistula is to be avoided. The tissues are carefully handled and the stump is usually stapled.
Ligate the pulmonary vein
Ligate pulmonary artery
Divide the bronchus
Perform lymphnode clearance