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.