SLEEVE PNEUMONECTOMY FOR PRIMARY LUNG CANCER INVOLVED BOTH CARINA AND TRUNKS INTERMEDIUS-A CASE REPORT-

Abstract

We have experienced a case of sleeve pneumonectomy for a squamous cell cell cacinoma of the lung invading the carina and trunks intermedius. A 69 year-old man who was under treatment for diabetes, hypertention and coniosis at another hospital was admitted to our hospital because of exertional dyspnea. Chestroentgenogram showed atelectasis of the right upper lobe. Computed tomogram and magnetic resonance imaging revealed a lesion involved the near carina. Bronchoscopic examination visualized that the tumor arised in the right upper lobe bronchus and invaded both the right wall of the carina and trunks intermedius. No vascular involvement was present. To perform a complete excision of the affected portion of bronchus, a sleeve pneumonectomy was performed and carinal reconstruction was successfully carried out with a telescoping tracheo-bronchial anastomosis. The anastomosis was wrapped with pericardial fat tissue. Hlstopathologically, it was well differentiated squamous cell carcinoma of t₄n₀m₀ in stage IIIb. The postoperative course was uneventful, and a bronchoscopy revealed good a anastomotic healing without stenosis or granulation. The patient has been free from cancer as of 15 months after the operation.