Abstract
A right sleeve pneumonectomy was performed on a 65-year-old patient who had a squamous cell carcinoma invading the trachea and right intermediate bronchus. A posterolateral incision was made under general anesthesia. The right main pulmonary artery, superior and inferior pulmonary veins were cut. The mediastinal lymph nodes were dissected and a right pneumonectomy was performed, with a cutting the carinal portion. An end-to-end anastomosis between the trachea and the left main bronchus was performed with a 4-0 absorbable suture. Two kinds of experimental tracheal reconstruction were performed using allografts from the trachea and carina. For the tracheal transplant, a graft with 6 rings was removed from a donor dog. This was interposed into the defective region of a recipient dog in which 14 rings of the trachea had been removed. Omentum was wrapped around the graft. For the carinal transplant, carina with 2 rings of the trachea, 1 ring of the right main bronchus and 2 rings of the left main bronchus were removed from a donor dog for a graft. This was also interposed into the defective region of a recipient dog in which a long Y-shaped carina with 9 rings of the trachea, 4 rings of the left main bronchus and 2 rings of the right main bronchus had been removed.
In these experiments, good healing of the grafts were observed under the bronchofiberscope, and these dogs have shown long-term survival.
