2011 Volume 25 Issue 1 Pages 048-053
A 29-year-old man was diagnosed with an adenoid cystic carcinoma arising from the left main bronchus. The lesion extended to the lower part of trachea and the right main bronchus. Left sleeve pneumonectomy was performed through a median sternotomy, taking account of the use of cardiopulmonary bypass and wrapping the anastomosis with omentum on the resection and reconstruction of the long segment of the respiratory tract. Because the tumor invaded the bifurcation of the pulmonary trunk, left pneumonectomy was initially performed. On cardiopulmonary bypass, en-bloc resections of the left branch of the pulmonary trunk, the distal five tracheal rings, and two rings of the proximal right main bronchus including the carina were accomplished, followed by smooth reconstruction. The postoperative course was uneventful, adopting temporary mechanical ventilation after the procedure. Although left sleeve pneumonectomy is still an uncommon and technically extremely demanding operation characterized by a high risk of morbidity and mortality, the present case shows that excellent outcomes can still be achieved with appropriate patient selection, precise techniques, and optimal perioperative planning.
