ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Tracheal sleeve pneumonectomy: an analysis of 13 cases
İrfan Taştepe1, Suat Gezer2, Gürhan Öz1, Taner Ege1, Erkmen Gülhan1, Ülkü Yazıcı1, Esra Özaydın3, Pınar Yaran1
1Departments of Thoracic Surgery, Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara
2Department of Thoracic Surgery, Medicine Faculty of Düzce University, Düzce
3Departments of Pathology, Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara
DOI : 10.5606/tgkdc.dergisi.2011.017
Background: In this study, we evaluated the results of our tracheal sleeve pneumonectomy (TSP) cases.

Methods: Thirteen male patients (mean age 52; range 40 to 65 years) with non-small cell lung cancer underwent TSP in our clinic between January 2000 and July 2009. The patients were evaluated for age, sex, histopathological examinations and stages, adjuvant therapies, postoperative complications and survival retrospectively. The mean and five-year survivals of patients were analyzed with Kaplan- Meier method.

Results: Eleven right and two left TSPs were performed in 13 patients. The histopathological diagnoses were squamous cell carcinoma in 11 patients, adenocarcinoma in one patient and adeno-squamous carcinoma in one patient. The tumor-node-metastasis staging was stage IIB in one patient, stage IIIA in one patient and stage IIIB in 11 patients. Four patients had complications after the surgery, and two of these were anastomosis-related. A total of three patients died during follow-up, one of them in the postoperative period. The mean survival and the five-year survival rate were 87 months and 77%, respectively.

Conclusion: Tracheal sleeve pneumonectomy is an important modality in the treatment of lung cancer that has invaded or is in close proximity with the carina. With improvements in the thoracic surgery, the morbidity and mortality of TSP have improved and are currently close to the standard pneumonectomy. Mediastinal lymph node involvement should be a contraindication. The only exception for this is subcarinal lymph node involvement, where en block resection is possible.

Keywords : Carina resection; non-small cell lung cancer; tracheal sleeve pneumonectomy; tracheobronchial anastomosis
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