# A Novel Approach of Pericardial Suspension Method Combined with Tracheobronchial Stent Placement: A Life-Saving Case for Right Main Bronchial Stenosis

## TL;DR

A new surgical method combining pericardial suspension and stent placement successfully treated severe bronchial stenosis in a cancer patient.

## Contribution

A novel surgical approach combining pericardial suspension and stent placement for treating bronchial stenosis is introduced.

## Key findings

- The patient's respiratory distress improved significantly after the novel surgical intervention.
- Pericardial suspension corrected extrinsic mediastinal shift, enabling safe stent placement.
- The method may be essential for treating secondary tracheobronchomalacia in adults.

## Abstract

There is no consensus regarding surgery and endotracheal treatment for bronchial stenosis. We report a case of right main bronchus stenosis treated using a novel approach of mediastinal mobilization with pericardial suspension.

A 57-year-old woman who developed radiation pneumonitis after postoperative radiation therapy for left breast cancer was admitted to our hospital due to worsening respiratory distress over 2 years. Chest CT revealed severe stenosis of the right main bronchus owing to lung destruction and scoliosis. Although isolated lung ventilation using a double-lumen tube was initiated, the ventilation was unstable. The patient underwent surgery, including sternal elevation using the Nuss technique, mediastinal mobilization using pericardial suspension, and tracheobronchial stenting to ameliorate bronchial stenosis.

After surgery, oxygenation was no longer required. This novel pericardial suspension technique fundamentally corrects the extrinsic mediastinal shift, serving as an essential prerequisite for safe stenting against secondary tracheobronchomalacia in adult cases.