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The surgical technique for complete resection of lung cancer invading the intrapericardial pulmonary vein and left atrium

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Abstract

In patients with lung cancer invading the left atrium, performing complete resection is difficult. In many cases of complete resection, pneumonectomy is performed. We herein report two techniques in which complete resection with negative margins at the intrapericardial pulmonary vein and left atrium was achieved without pneumonectomy. In the first technique, the groove of the pericardium between the right and left atrium was dissected and an atrial cuff was made in a manner that elongated the intrapericardial pulmonary vein. In the second technique, traction was applied to the atrial cuff, and only the middle lobe vein of the elongated pulmonary vein was resected, to perform atrial cuff plasty. The upper lobe vein and inferior pulmonary vein could be preserved. These techniques of PV elongation and atrial cuff plasty are suitable for both achieving complete resection and lung preservation for lung cancer patients with invasion of the left atrium.

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Abbreviations

SPV:

Superior pulmonary vein

IPV:

Inferior pulmonary vein

SVC:

Superior vena cava

PA:

Pulmonary artery

COPD:

Chronic occlusive pulmonary disease

FVC:

Forced Vital Capacity

FEV1.0:

Forced expiratory volume in one second

DLco:

Diffusing capacity of lungs for carbon monoxide

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Authors and Affiliations

  1. Thoracic Surgery Division, 2nd Department of Surgery, University of Occupational and Environmental Health, 1-1 Iseigaoka Yahatanishiku, Kitakyushu, Japan

    Koji Kuroda, Masataka Mori, Syuichi Shinohara, Rintaro Oyama, Hiroki Matsumiya, Masatoshi Kanayama, Akihiro Taira, Shinji Shinohara, Taiji Kuwata & Fumihiro Tanaka

Authors
  1. Koji Kuroda
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  2. Masataka Mori
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  3. Syuichi Shinohara
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  4. Rintaro Oyama
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  5. Hiroki Matsumiya
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  6. Masatoshi Kanayama
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  7. Akihiro Taira
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  8. Shinji Shinohara
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  9. Taiji Kuwata
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  10. Fumihiro Tanaka
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Correspondence to Koji Kuroda.

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Supplementary Video 1: The surgical treatment was right middle lobectomy with the combined resection of the left atrium and lymph node dissection. The operative time was 3 h 18 min. The bleeding volume was 40 ml. The upper side is the cranial side. (MP4 74006 kb)

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Kuroda, K., Mori, M., Shinohara, S. et al. The surgical technique for complete resection of lung cancer invading the intrapericardial pulmonary vein and left atrium. Surg Today 51, 452–456 (2021). https://doi.org/10.1007/s00595-020-02089-1

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  • DOI: https://doi.org/10.1007/s00595-020-02089-1

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