title: Reconstruction of the pulmonary trunk via cardiopulmonary bypass in extended resection of locally advanced lung malignancies.
abstract: OBJECTIVE
  The aim of this retrospective study is to summarize our improvement of surgical procedures for radical resection of left hilar tumors involving the pulmonary trunk and determine its clinical feasibility.
  
  
  METHODS
  From 2001 to 2008, four patients were selected for curative extended resection through multidisciplinary assessment and the pulmonary trunk was reconstructed via cardiopulmonary bypass (CPB). Surgical procedures were performed with posterolateral thoracotomy for two patients and anterolateral thoracotomy for the remaining two. CPB was performed via femoral artery-femoral vein cannulation on one patient and right atrial-aortic cannulation on the other three patients. Polytetrafluoroethylene patch or autologous pericardium was applied for reconstruction in different patients.
  
  
  RESULTS
  The duration of the operations ranged from 300 to 440 min and with CPB lasting 35-106 min. Three patients developed non-specific complications with no mortalities and discharged within 12-17 days. One patient had no evidence of recurrence during 50 months follow-up. Three patients died of metastasis 5, 14, and 35 months after surgery.
  
  
  CONCLUSIONS
  CPB-supported extended resection of lung malignancies involving the pulmonary trunk is feasible. Left anterolateral thoracotomy through the fourth intercostal space with right atrial-aortic cannulation would be the convenient approach. Survival may be prolonged in some selected patients.
authors: Department of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu, China.
authors: Jiandong
authors: J
authors: Mei
authors: Qiang
authors: Q
authors: Pu
authors: Yunke
authors: Y
authors: Zhu
authors: Lin
authors: L
authors: Ma
authors: Fuqiang
authors: F
authors: Ren
authors: Guowei
authors: G
authors: Che
authors: Lunxu
authors: L
authors: Liu
mesh_terms: D000328:Adult; D000368:Aged; D002296:Carcinosarcoma / Q000401:mortality / Q000473:pathology / Q000601:surgery; D002315:Cardiopulmonary Bypass / Q000379:methods*; D005240:Feasibility Studies; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011651:Pulmonary Artery / Q000473:pathology / Q000601:surgery*; D011667:Pulmonary Veins / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D012208:Rhabdomyosarcoma / Q000401:mortality / Q000473:pathology / Q000601:surgery; D055752:Small Cell Lung Carcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery; D013908:Thoracotomy