Abstract
Modern surgical and anesthetic technique permits the resection of non-small cell lung cancers involving the tracheal carina. Retrospective reviews suggest a surgical mortality below 10 % and 5-year survival approaching 40 % in selected patients. Despite the use of induction therapy, fewer than 15 % of patients with mediastinal lymph node metastases survive 5 years and patients not responsive to induction should not be considered for surgery. The most serious complications are anastomotic dehiscence and acute respiratory distress syndrome (ARDS), which may be minimized with careful patient selection, surgical technique and airway management intra- and post-operatively.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Jensik RJ, Faber LP, Kittle CF, Miley RW, Thatcher WC, El-Baz N. Survival in patients undergoing tracheal sleeve pneumonectomy for bronchogenic carcinoma. J Thorac Cardiovasc Surg. 1982;84(4):489–96.
Watanabe Y, Shimizu J, Oda M, Hayashi Y, Watanabe S, Yazaki U, Iwa T. Results in 104 patients undergoing bronchoplastic procedures for bronchial lesions. Ann Thorac Surg. 1990;50(4):607–14.
Mathisen DJ, Grillo HC. Carinal resection for bronchogenic carcinoma. J Thorac Cardiovasc Surg. 1991;102(1):16–22.
Roviaro GC, Varoli F, Rebuffat C, Scalambra SM, Vergani C, Sibilla E, Palmarini L, Pezzuoli G. Tracheal sleeve pneumonectomy for bronchogenic carcinoma. J Thorac Cardiovasc Surg. 1994;107(1):13–8.
Ayabe H, Tagawa Y, Tsuji H, Kawahara K, Akamine S, Takahashi T, Hara S, Tomita M. Results of carinal resection for bronchogenic carcinoma. Tohoku J Exp Med. 1995;175(2):91–9.
Dartevelle P, Macchiarini P. Carinal resection for bronchogenic cancer. Semin Thorac Cardiovasc Surg. 1996;8(4):414–25.
Mitchell JD, Mathisen DJ, Wright CD, Wain JC, Donahue DM, Moncure AC, Grillo HC. Clinical experience with carinal resection. J Thorac Cardiovasc Surg. 1999;117(1):39–52.
Mitchell JD, Mathisen DJ, Wright CD, Wain JC, Donahue DM, Allan JS, Moncure AC, Grillo HC. Resection for bronchogenic carcinoma involving the carina: long-term results and effect of nodal status on outcome. J Thorac Cardiovasc Surg. 2001;121(3):465–71.
Porhanov VA, Poliakov IS, Selvaschuk AP, Grechishkin AI, Sitnik SD, Nikolaev IF, Efimtsev JP, Marchenko LG. Indications and results of sleeve carinal resection. Eur J Cardiothorac Surg. 2002;22(5):685–94.
Regnard J, Perrotin C, Giovannetti R, Schussler O, Petino A, Spaggiari L, Alifano M, Magdeleinat P. Resection for tumors with carinal involvement: technical aspects, results, and prognostic factors. Ann Thorac Surg. 2005;80:1841–6.
de Perrot M, Fadel E, Mercier O, Mussot S, Chapelier A, Dartevelle P. Long-term results after carinal resection for carcinoma: does the benefit warrant the risk? J Thorac Cardiovasc Surg. 2006;131(1):81–9.
Macchiarini P, Altmayer M, Go T, Walles T, Schulze K, Wildfang I, Haverich A, Hardin M, Hannover Interdisciplinary Intrathoracic Tumor Task Force Group. Technical innovations of carinal resection for nonsmall-cell lung cancer. Ann Thorac Surg. 2006;82(6):1989–97.
Yamamoto K, Miyamoto Y, Ohsumi A, Imanishi N, Kojima F. Results of surgical resection for tracheobronchial cancer involving the tracheal carina. Gen Thorac Cardiovasc Surg. 2007;55(6):231–9; discussion 238–9.
Rea F, Marulli G, Schiavon M, Zuin A, Hamad AM, Feltracco P, Sartori F. Tracheal sleeve pneumonectomy for non small cell lung cancer (NSCLC): short and long-term results in a single institution. Lung Cancer. 2008;61(2):202–8.
Jiang F, Xu L, Yuan F, Huang J, Lu X, Zhang Z. Carinal resection and reconstruction in surgical treatment of bronchogenic carcinoma with carinal involvement. J Thorac Oncol. 2009;4(11):1375–9.
Go T, Altmayer M, Richter M, Macchiarini P. Decompressing manubriectomy under apneic oxygenation to release the median thoracic outlet compartment in Bechterew disease. J Thorac Cardiovasc Surg. 2003;126(3):867–9.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2014 Springer-Verlag London
About this chapter
Cite this chapter
Millington, T.M., Gaissert, H.A. (2014). Carinal Resection for Non Small Cell Lung Cancer. In: Ferguson, M. (eds) Difficult Decisions in Thoracic Surgery. Difficult Decisions in Surgery: An Evidence-Based Approach, vol 1. Springer, London. https://doi.org/10.1007/978-1-4471-6404-3_45
Download citation
DOI: https://doi.org/10.1007/978-1-4471-6404-3_45
Published:
Publisher Name: Springer, London
Print ISBN: 978-1-4471-6403-6
Online ISBN: 978-1-4471-6404-3
eBook Packages: MedicineMedicine (R0)