A new approach to left sleeve pneumonectomy: complete VATS left pneumonectomy followed by right thoracotomy for carinal resection and reconstruction

Fujino, Toshio; Tanahashi, Masayuki; Yukiue, Haruhiro; Suzuki, Eriko; Yoshii, Naoko; Shitara, Masayuki; Kaminuma, Yasunori; Niwa, Hiroshi

doi:10.1186/s40792-018-0496-2

“…The only exception is the study by Fujino and coworkers, who chose to start the procedure with the left thoracoscopy and pneumonectomy first, since an evaluation of tumor extension into the aortopulmonary window was deemed necessary (7).…”

Section: Discussionmentioning

confidence: 99%

Combined right thoracotomy and left video-assisted thoracoscopic surgery for left tracheal sleeve pneumonectomy: a case report

Mammana¹,

Comacchio²,

Pangoni³

et al. 2021

J Vis Surg

0

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Left tracheal sleeve pneumonectomy (LTSP) is a challenging operation and traditional surgical approaches have their downsides. We describe the case of a 38-year-old patient affected by adenoid cystic carcinoma of the left main bronchus and the carina who underwent surgical excision of his tumor through a bilateral approach. En bloc tumor and carinal resection, followed by right main bronchial reimplantation were performed through right thoracotomy; while the left pneumonectomy was completed through a contralateral uniportal thoracoscopic approach. This is the seventh reported case of LTSP performed through a combined open and thoracoscopic approach. Some details, such as the side of the operation to approach first and the method of intraoperative ventilation, vary between reports; however, globally, the reported outcomes seem favorable. The growing number of published cases suggests that such approach should be acknowledged as a reasonable alternative to traditional surgical accesses for LTSP.

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“…In the other reported cases, the combined approach consisted most often of a right thoracotomy first, for carinal resection and reimplantation of the right main bronchus, and a subsequent left VATS, for completion of the pneumonectomy. The only exception is the study by Fujino and coworkers, who chose to start the procedure with the left thoracoscopy and pneumonectomy first, since an evaluation of tumor extension into the aortopulmonary window was deemed necessary (7).…”

Section: Discussionmentioning

confidence: 99%

“…Although the patients' number is low and there is potential for publication bias, overall, the postoperative outcomes of the reported cases seem favorable. Only one patient died in the postoperative period (6), due to a presumed respiratory tract bleeding, while two patients experienced complications that resulted in a prolonged hospital stay (3,7).…”

Section: B Amentioning

confidence: 99%

Combined right thoracotomy and left video-assisted thoracoscopic surgery for left tracheal sleeve pneumonectomy: a case report

Mammana¹,

Comacchio²,

Pangoni³

et al. 2021

J Vis Surg

0

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Left tracheal sleeve pneumonectomy (LTSP) is a challenging operation and traditional surgical approaches have their downsides. We describe the case of a 38-year-old patient affected by adenoid cystic carcinoma of the left main bronchus and the carina who underwent surgical excision of his tumor through a bilateral approach. En bloc tumor and carinal resection, followed by right main bronchial reimplantation were performed through right thoracotomy; while the left pneumonectomy was completed through a contralateral uniportal thoracoscopic approach. This is the seventh reported case of LTSP performed through a combined open and thoracoscopic approach. Some details, such as the side of the operation to approach first and the method of intraoperative ventilation, vary between reports; however, globally, the reported outcomes seem favorable. The growing number of published cases suggests that such approach should be acknowledged as a reasonable alternative to traditional surgical accesses for LTSP.

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“…In our observation, the treatment was surgical from the start, based on an enlarged left pneumonectomy to the carina and the trachea with anastomosis between the RMB and the trachea. Left sleeve pneumonectomy is a rare and complex procedure in thoracic surgery [1] , [6] . The first successful case of left carinal pneumonectomy was reported in 1969 for adenoid cystic carcinoma in the left mainstem bronchus [7] .…”

Section: Discussionmentioning

confidence: 99%

Left sleeve pneumonectomy for a rare lung tumor: A case report

Bouacida

¹

,

Bousnina

²

,

Zribi

³

et al. 2021

International Journal of Surgery Case Reports

1

0

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Introduction and importance Primary adenoid cystic carcinoma (ACC) of the lung is extremely rare. This tumor can be asymptomatic or have non characteristics symptoms, and the diagnosis is often late. The treatment of choice is surgery when it's possible. Case presentation We herein report the case of a young patient with ACC of the left main bronchus. He had dyspnea and chest pain for 6 months. Complete atelectasis of the left lung was found on the chest x-ray. Bronchoscopy showed a tumor obstructing the LMB and invading the carina. The CT scan revealed a 5 cm tumor obstructing the left main bronchus (LMB) with extension to the carina and thoracic trachea. The extension assessment was without abnormalities. The treatment was surgical. A left carinal pneumonectomy by double lateral thoracotomy was performed. The postoperative results were satisfactory. There was no recurrence with a follow-up of 2 years. Clinical discussion The therapeutic management of ACC is essentially based on surgical resection, which should be as radical as possible. However, complete resection is often difficult given the infiltrating nature of the tumor. Conclusion Sleeve pneumonectomy with carinal resection is a curative option for patients with ACC of the main bronchi and carina that require expertise of the surgeons.

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A new approach to left sleeve pneumonectomy: complete VATS left pneumonectomy followed by right thoracotomy for carinal resection and reconstruction

Cited by 8 publications

References 4 publications

Combined right thoracotomy and left video-assisted thoracoscopic surgery for left tracheal sleeve pneumonectomy: a case report

Combined right thoracotomy and left video-assisted thoracoscopic surgery for left tracheal sleeve pneumonectomy: a case report

Combined right thoracotomy and left video-assisted thoracoscopic surgery for left tracheal sleeve pneumonectomy: a case report

Left sleeve pneumonectomy for a rare lung tumor: A case report

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