Tracheobronchial Plasty with Special Reference to Carinal Resection

Abstract

Recently cases of carinal resection have increased. We have performed 6 carinal resections; 5 for lung cancer and 1 for tuberculous stenosis. Sleeve pneumonectomy was carried out in 4 cases. In the remaining 2 cases, the trachea was sutured to the right bronchus intermedius and to the left main bronchus.
Right posterolateral incision was made in 4 cases and median sternotomy was made in 2 cases. Median sternotomy is the favorable incision for selected cases. Three of the 6 patients who underwent carinal resections died within a month, 1 died of myocardial infarction, 1 died of disruption of suture line and 1 died of pneumonia.
One case with Y-shaped reconstrution died of massive hemoptysis during laser surgery to the granulation tissue at the anastomotic site. Autopsy revealed bronchopulmonary arterial fistula.
In carinal resections complications frequently occur, postoperative mortality rate is high and the number of long-term survivors is small as compared to that with standard resections. Postoperative management is very important.