CONCOMITANT RESECTION AND RECONSTRUCTION OF THE DESCENDING AORTA IN ADVANCED LUNG CANCER

Abstract

Two patients with advanced lung cancer involving the aortic wall underwent concomitant resection and reconstruction of the aorta under a temporary bypass.
Case 1: A 62-year-old male had a left hilar lesion with severe stenosis of the main bronchus and athelectasis of the lower lobe. Left pneumonectomy combined with resection of the descending aorta was undertaken. The aorta was reconstituted with Dacron graft interposition. The pathological diagnosis was squamous cell carcinoma and the tumor extended to the media of the aortic wall. The postoperative course was uneventful. However, he died of acute pneumonia 12 months after surgery.
Case 2: A 64-year-old male was found to have a left upper lobe lesion and underwent left upper lobectormy combined with resection of the descending aorta, which was reconstituted with end-to-end anastomosis. The pathological diagnosis was adenocarcinoma and the tumor extension was restricted to the adventia. The postoperative course was uneventful and he is alive at present, seven months after surgery.
Even in advanced lung cancer involving the aorta, concomitant resection and reconstruction of the aorta may be justified if longer survival and higher curability are expected.