Left sleeve pneumonectomy via a clamshell incision for lung cancer with carinal invasion: report of a case.
Surgery for lung cancer involving the carina is challenging as it requires special surgical techniques and airway management. We report how we successfully treated carinal invasion of primary lung cancer by performing left sleeve pneumonectomy through a clamshell incision, as bilateral thoracotomy through a transverse sternotomy. Without a cardiopulmonary assist device, adequate ventilation and oxygenation were maintained across the operative field with a spinal tube. Tracheo-bronchial anastomosis was relatively easy to perform, with an excellent surgical view. The patient had an uneventful postoperative course and was discharged from hospital without oxygen support. There was no evidence of complications at the anastomosis on chest computed tomography and no sign of recurrence during 6 months of follow-up. The clamshell incision approach provided an excellent surgical view without the need to change the position of the patient during the operation. Thus, it could prove a useful procedure for carinal surgery; especially left sleeve pneumonectomy.
Division of Surgical Oncology, Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, Japan. miyataku@nagasaki-u.ac.jp
Takuro
T
Miyazaki
Naoya
N
Yamasaki
Tomoshi
T
Tsuchiya
Keitaro
K
Matsumoto
Koichi
K
Tomoshige
Kuniko
K
Abe
Tomayoshi
T
Hayashi
Takeshi
T
Nagayasu
D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D001984:Bronchial Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011013:Pneumonectomy / Q000379:methods*; D011859:Radiography; D013908:Thoracotomy / Q000379:methods*; D016896:Treatment Outcome