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

Abstract

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.