Two-stage operation for endobronchial lipoma and lung cancer using bronchoscopy and thoracoscopy in an elderly patient with chronic obstructive pulmonary disease.

We present an 82-year-old man with chronic obstructive pulmonary disease with endobronchial lipoma, obstructing the right lower lobe bronchus, and lung adenocarcinoma in the peripheral lung of the right upper lobe (clinically T1N0M0). The endobronchial lipoma was thus first removed by bronchoscopic snaring forceps and laser therapy, resulting in an improvement of the pulmonary function. One month later, the lung adenocarcinoma was removed using thoracoscopy. The postoperative course was satisfactory, and the patient is now doing well without any tumor recurrence 11 months after surgery. For elderly chronic obstructive pulmonary disease patients with endobronchial lipoma and T1N0M0 lung cancer, a two-stage operation, consisting of bronchoscopic resection followed by a thoracoscopic resection for lung cancer, was found to be a safe and effective method of treatment while maintaining sufficient pulmonary function.