Resection for Tumors With Carinal Involvement: Technical Aspects, Results, and Prognostic Factors

Regnard, Jean François; Perrotin, C.; Giovannetti, Riccardo; Schussler, Olivier; Petino, Antonio; Spaggiari, Lorenzo; Alifano, Marco; Magdeleinat, Pierre

doi:10.1016/j.athoracsur.2005.04.032

Cited by 101 publications

(106 citation statements)

References 12 publications

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“…The postoperative mortality for sleeve pneumonectomy has been reported to range from 6.1% to 7.5%, and the overall 5-year survival rate ranges from 26.5% to 33.4%. [2][3][4] These results seem to be acceptable compared to those of standard pneumonectomy.…”

Section: Discussionmentioning

confidence: 77%

“…Many reports have recommended that patients with N2 disease resistant to preoperative chemotherapy and/or radiotherapy should be excluded from this procedure. [2][3][4][5] Moreover, left sleeve pneumonectomy is rarely indicated, since the left main bronchus is considerably longer than the right one, and, in the case of carinal involvement, the tumor usually involves the structures in the subaortic space as well, which automatically implies inoperability. 5 Rea et al 2 reported that just one left pneumonectomy was done among 49 patients who underwent carinal resection.…”

Section: Discussionmentioning

confidence: 99%

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Left sleeve pneumonectomy via a clamshell incision for lung cancer with carinal invasion: report of a case

et al. 2011

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Surgery for lung cancer involving the carina has been a challenge due to surgical technique and airway management. A case that was successfully treated with left sleeve pneumonectomy performed through a clamshell incision (bilateral thoracotomy through a transverse sternotomy) for carinal invasion of primary lung cancer, is reported.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 the excellent surgical view. The patients' postoperative course was uneventful, and chest CT showed no complications at the anastomosis. The patient was discharged without oxygen support. There has been no evidence of recurrence during 6 months of follow-up.A clamshell incision approach provided an excellent surgical view without changing the position of the patient during the operation and could be a useful procedure for carinal surgery, especially for left sleeve pneumonectomy.

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Left sleeve pneumonectomy via a clamshell incision for lung cancer with carinal invasion: report of a case

et al. 2011

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“…Although technical complexity of these procedures remains high and only few centres worldwide have obtained a wide range of experience, in the last decade the operative mortality has been reported under 10% with 5-year survival rates ranging between 33% and 44% (table 4) [56,[58][59][60][61][62][63][64].…”

Section: Carinal Resectionsmentioning

confidence: 99%

Tracheal surgery

D’Andrilli

Rendina

Venuta

2016

Monaldi Arch Chest Dis

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Surgical resection and reconstruction of the trachea can be performed both for benign and malignant diseases. The main indications for surgery include inflammatory (generally post-intubation), congenital or post-traumatic stenoses, degenerative lesions, benign or malignant neoplasms. Success can be pursued only by accurate patient selection and timing, meticulous surgical techniques, careful follow up and, when required, multidisciplinary cooperation. Although surgical resection has now become part of our surgical practice, other treatment modalities are approaching a new clinical application era, in particular tracheal transplantation and bioengineering. These new techniques will certainly offer, in the near future, improved chances to treat difficult cases.

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“…Rarely, cardiopulmonary bypass is required [131]. Isolated tracheobronchial resections can be performed without lung resections, but in many cases a lobectomy or a pneumonectomy is necessary [130,[132][133][134]. Perioperative mortality remains high: 2.5% to 15% in most series.…”

Section: Carinal Resections and Sleeve Pneumonectomiesmentioning

confidence: 99%

“…3). Resection of lung cancer involving the carina remains a challenge because of specific technical problems and airway management [130]. The intraoperative airway management consists of high-frequency jet ventilation or intermittent conventional ventilation through the operative field.…”

Section: Carinal Resections and Sleeve Pneumonectomiesmentioning

confidence: 99%

Surgery for nonsmall cell lung cancer

Lang-Lazdunski

2013

Eur Respir Rev

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Surgery remains the best curative option in patients with early stage lung cancer (stage I and II). Developments in minimally invasive techniques now allow surgeons to perform lung resections on elderly patients, patients with poor pulmonary function or significant cardiopulmonary comorbidities. New techniques, such as stereotactic radiotherapy and ablative procedures, are being evaluated in early-stage lung cancer and may represent an alternative to surgery in patients unfit for lung resection. Perioperative mortality rates have dropped significantly at most institutions in the past two decades and complications are managed more efficiently. Progress in imaging and staging techniques have helped cut futile thoracotomy rates and offer patients the most adequate treatment options. Large randomised trials have helped clarify the role of neoadjuvant, induction and adjuvant chemotherapy, as well as radiotherapy. Surgery remains an essential step in the multimodality therapy of selected patients with advanced-stage lung cancer (stage III and IV). Interventional and endoscopic techniques have reduced the role of surgery in the diagnosis and staging of nonsmall cell lung cancer, but surgery remains an important tool in the palliation of advanced-stage lung cancer. Large national/international surgical databases have been developed and predictive risk-models for surgical mortality/morbidity published by learned surgical societies. Nonetheless, lung cancer overall survival rates remain deceptively low and it is hoped that early detection/screening, better understanding of tumour biology and development of biomarkers, and development of efficient targeted therapies will help improve the prognosis of lung cancer patients in the next decade. @ERSpublications Despite progress in surgical techniques, radiotherapy techniques and targeted therapy, lung cancer prognosis remains poor

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Resection for Tumors With Carinal Involvement: Technical Aspects, Results, and Prognostic Factors

Cited by 101 publications

References 12 publications

Left sleeve pneumonectomy via a clamshell incision for lung cancer with carinal invasion: report of a case

Left sleeve pneumonectomy via a clamshell incision for lung cancer with carinal invasion: report of a case

Tracheal surgery

Surgery for nonsmall cell lung cancer

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