ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Results of carinal sleeve lobectomy and sleeve pneumonectomy for lung carcinoma
Alpay Sarper1, Tülin Aydoğdu Titiz2, Necdet Öz3, Gökhan Arslan4, Hakan Bozcuk5, Abid Demircan1
1Akdeniz Üniversitesi Tıp Fakültesi, Göğüs Cerrahisi Anabilim Dalı, Antalya
2Akdeniz Üniversitesi Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Antalya
3Antalya Atatürk Devlet Hastanesi, Göğüs Cerrahisi Kliniği, Antalya
4Akdeniz Üniversitesi Tıp Fakültesi, Radyoloji Anabilim Dalı, Antalya
5Akdeniz Üniversitesi Tıp Fakültesi, Onkoloji Bilim Dalı, Antalya
Background: This study presents our surgical procedure and results of treatment for nonsmall cell lung cancer invading the carina.

Methods: Between June 2002 and March 2009 in our clinic, 15 patients (13 males, 2 females; mean age 56.7 years; range 36 to 68 years) who underwent carinal resection for non-small cell lung cancers (11 squamous cell carcinomas, 2 adenocarcinomas, 1 adenosquamous carcinoma and 1 giant cell carcinoma) were included in this study. According to preoperative staging, there was no mediastinal lymph node involvement in all patients. Eleven patients underwent carinal pneumonectomies (10 rights, 1 left), and four patients had carinal right upper lobectomies performed. The operative approach was lateral thoracotomy in all patients. In addition to carinal resection one underwent partial resection of the vena cava superior, two partial pericardial resection and one patient underwent adrenalectomy for the metastases.

Results: Operative mortality and morbidity were 6.6% (n=1) and 33.3% (n=5), respectively. The most common complications were prolonged air leak and empyema. Four patients had positive N2 nodes, and five patients had positive N1 nodes postoperatively. Mean recurrence free survival period was 40 months (95% CI: 17.2-63.2) and median recurrence free survival period was 12.2 month (95% CI: 9-15,4; CI: confidence interval).

Conclusion: Surgical intervention for carcinoma involving the carina is feasible, with acceptable mortality and good survival in selected patients.

Keywords : Bronchial carcinoma; carinoplasty; sleeve pneumonectomy
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