scholarly journals Right sleeve pneumonectomy for local recurrent lung cancer following right sleeve upper lobectomy with bronchoplasty: A case report

2020 ◽  
Author(s):  
Jun Hanaoka ◽  
Yo Kawaguchi ◽  
Keigo Okamoto ◽  
Ryosuke Kaku ◽  
Yasuhiko Ohshio
Keyword(s):  
Lung Cancer ◽  
Salvage Surgery ◽  
Main Bronchus ◽  
Median Sternotomy ◽  
Sleeve Lobectomy ◽  
Airway Reconstruction ◽  
Proximal Site ◽  
Right Pulmonary Artery ◽  
Post Operation ◽  
The Right

Abstract Background Salvage surgery has been frequently performed, increasing the opportunity to actively perform surgery for recurrence after a function-preserving operation. However, re-operation after airway reconstruction surgery on the proximal side and the effect of prior treatment, such as radiotherapy and/or chemotherapy, make the operation more difficult. In addition, cases of sleeve pneumonectomy after sleeve lobectomy with bronchoplasty are uncommon. Case presentation A 71-year-old lung cancer patient underwent right upper sleeve lobectomy with bronchoplasty combined with perioperative chemotherapy about 11 years ago. A new undiagnosed right hilar mass that appeared 9 years post-operation showed a temporary response to radiotherapy but progressed thereafter. Sleeve pneumonectomy was completed 14 months after radiotherapy by the following procedures: dividing the right pulmonary artery at the proximal site under median sternotomy and then reconstructing the bronchus by telescoping the left main bronchus into the distal trachea after pneumonectomy under posterolateral thoracotomy. Conclusions Sleeve pneumonectomy could be safely performed under good vision using a two-stage approach as salvage surgery, even in high-risk patients who received various treatments and proximal airway reconstruction.

scholarly journals Right sleeve pneumonectomy for local recurrent lung cancer following right sleeve upper lobectomy with bronchoplasty: A case report

2020 ◽  
Author(s):  
Jun Hanaoka ◽  
Yo Kawaguchi ◽  
Keigo Okamoto ◽  
Ryosuke Kaku ◽  
Yasuhiko Ohshio
Keyword(s):  
Lung Cancer ◽  
Salvage Surgery ◽  
Main Bronchus ◽  
Median Sternotomy ◽  
Sleeve Lobectomy ◽  
Airway Reconstruction ◽  
Proximal Site ◽  
Right Pulmonary Artery ◽  
Post Operation ◽  
The Right

Abstract Background: Salvage surgery has been frequently performed, increasing the opportunity to actively perform surgery for recurrence after a function-preserving operation. However, re-operation after airway reconstruction surgery on the proximal side and the effect of prior treatment, such as radiotherapy and/or chemotherapy, make the operation more difficult. In addition, cases of sleeve pneumonectomy after sleeve lobectomy with bronchoplasty are uncommon.Case presentation: A 71-year-old lung cancer patient underwent right upper sleeve lobectomy with bronchoplasty combined with perioperative chemotherapy in 2007. A new undiagnosed right hilar mass that appeared 9 years post-operation showed a temporary response to radiotherapy but progressed thereafter. Sleeve pneumonectomy was completed 14 months after radiotherapy by the following procedures: dividing the right pulmonary artery at the proximal site under median sternotomy and then reconstructing the bronchus by telescoping the left main bronchus into the distal trachea after pneumonectomy under posterolateral thoracotomy. Conclusions: Sleeve pneumonectomy for recurrent lung cancer could be safely performed under good vision using a two-stage approach as salvage surgery, even in high-risk patients who received various treatments and proximal airway reconstruction.

Cardiovascular-associated tracheobronchial obstruction in children

2012 ◽  
Vol 23 (2) ◽  
pp. 233-238 ◽  
Author(s):  
Shen-Hao Lai ◽  
Sui-Ling Liao ◽  
Kin-Sun Wong
Keyword(s):  
Pulmonary Artery ◽  
Airway Obstruction ◽  
Main Bronchus ◽  
Main Pulmonary Artery ◽  
Diagnostic Tools ◽  
Radiographic Findings ◽  
Tracheal Compression ◽  
Airway Obstructions ◽  
Right Pulmonary Artery ◽  
The Right

AbstractTracheobronchial compression of cardiovascular origin is an uncommon and frequently unrecognised cause of respiratory distress in children. The compression may be due to encircling vessels or dilated neighbouring cardiovascular structures. Bronchoscopy and detailed radiography, especially computed tomography and magnetic resonance imaging, are among the most powerful diagnostic tools. Few previous reports have addressed the relationship between bronchoscopic findings and underlying cardiovascular anomalies. The objective of this study was to correlate bronchoscopic and radiographic findings in children with cardiovascular-associated airway obstruction. A total of 41 patients were recruited for the study. Patients with airway obstruction were stratified on the basis of the aetiology of the cardiovascular structures and haemodynamics into an anatomy-associated group and a haemodynamics-associated group. In the anatomy-associated group, stenosis and malacia were found with comparable frequency on bronchoscopy, and the airway obstructions were mostly found in the trachea (71% of patients). In the haemodynamics-associated group, malacia was the most common bronchoscopic finding (85% of patients), and nearly all locations of airway involvement were in the airway below the carina (90% of patients). The tracheal compression was usually caused by aberrant systemic branching arteries in the anatomy-associated group. In the haemodynamics-associated group, the causal relationships varied. Tracheal compression was often caused by lesions of the main pulmonary artery and aorta, whereas obstruction of the right main bronchus was caused by lesions of the main pulmonary artery and right pulmonary artery. The causes of left main bronchus compression were more diverse. In summary, the bronchoscopic presentations and locations are quite different between these two groups.

scholarly journals Unilateral Absence of the Right Pulmonary Artery Accompanied by Right Lung Cancer

2015 ◽  
Vol 100 (3) ◽  
pp. 1113 ◽  
Author(s):  
Yui Watanabe ◽  
Jotaro Shibuya ◽  
Masashi Handa ◽  
Tatsuaki Watanabe ◽  
Hirotsugu Notsuda ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Pulmonary Artery ◽  
Right Pulmonary Artery ◽  
The Right

Severe stenosis of a long tracheal segment, with agenesis of the right lung and left pulmonary arterial sling

2006 ◽  
Vol 16 (1) ◽  
pp. 89-91 ◽  
Author(s):  
Hamish M. Munro ◽  
Andrea M. C. Sorbello ◽  
David G. Nykanen
Keyword(s):  
Pulmonary Artery ◽  
Surgical Repair ◽  
Main Bronchus ◽  
Left Lung ◽  
Proximal Part ◽  
Pulmonary Vasculature ◽  
Severe Stenosis ◽  
Right Pulmonary Artery ◽  
Pulmonary Arterial ◽  
The Right

A baby presented at term with respiratory distress was managed with extracorporeal membrane oxygenation. Bronchoscopy revealed tracheal hypoplasia, complete tracheal rings, and agenesis of the right main bronchus. Echocardiography showed a left pulmonary arterial sling arising from the proximal part of the right pulmonary artery. Cardiac catheterization demonstrated abnormal pulmonary vasculature in the left lung which would have prevented survival, even after surgical repair. Diagnostic catheterization was important in delineating the anatomy, and aided in the decision not to proceed with surgical repair.

scholarly journals Robotic sleeve lobectomy with four arms for lung cancer centrally located in the right lower lobe: a case report

2017 ◽  
Vol 12 (1) ◽  
Author(s):  
Min Seop Jo ◽  
Do Yeon Kim ◽  
Jin Yong Jeong ◽  
Geun Dong Lee
Keyword(s):  
Lung Cancer ◽  
Case Report ◽  
Lower Lobe ◽  
Sleeve Lobectomy ◽  
The Right

Salvage surgery for lung cancer with tracheo-oesophageal fistula during concurrent chemoradiotherapy

2019 ◽  
Vol 29 (4) ◽  
pp. 641-643
Author(s):  
Isamu Watanabe ◽  
Kazuya Takamochi ◽  
Shiaki Oh ◽  
Kenji Suzuki
Keyword(s):  
Lung Cancer ◽  
Concurrent Chemoradiotherapy ◽  
Salvage Surgery ◽  
Mediastinal Lymph Node ◽  
Advanced Lung Cancer ◽  
Recurrent Nerve ◽  
Recurrent Nerve Palsy ◽  
Initial Surgery ◽  
The Right ◽  
Staged Reconstruction

Abstract A 48-year-old man presenting with cough, dysphagia and chest pain was diagnosed with advanced inoperable squamous cell carcinoma located in the right S2 with mediastinal lymph node metastases invading the oesophagus (c-T4N2M0 stage IIIB). Concurrent chemoradiotherapy (66 Gy) was planned, but he developed a tracheo-oesophageal fistula during the chemoradiotherapy course (26 Gy). A right sleeve pneumonectomy with oesophagectomy, cervical oesophagostomy and enterostomy were performed. Although bilateral recurrent nerve palsy occurred, he recovered via enhanced rehabilitation and was discharged 28 days after the salvage surgery. Three months after the initial surgery, staged reconstruction surgery of the stomach was performed. Intensive rehabilitation resulted in restored swallowing ability. He is alive with recurrent disease 12 months after surgery. This is the first report of salvage surgery for advanced lung cancer with tracheo-oesophageal fistula during concurrent chemoradiotherapy.

scholarly journals Aortogenic embolic stroke after sleeve pneumonectomy with median sternotomy for lung cancer: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Hirotoshi Suzuki ◽  
Masafumi Noda ◽  
Tatsuaki Watanabe ◽  
Yasushi Matsuda ◽  
Yasushi Hoshikawa ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Main Bronchus ◽  
Anticoagulation Therapy ◽  
Median Sternotomy ◽  
Lung Ventilation ◽  
Ascending Aorta ◽  
Embolic Stroke ◽  
Lower Trachea ◽  
Diseased Lung

Abstract Background The median sternotomy approach in sleeve pneumonectomy enables diseased lung ventilation in selected cases, which may reduce the difficulty in achieving anastomosis under intubation of the left main bronchus. However, with median sternotomy, the ascending aorta requires repeated mobilization to expose the operative field for anastomosis, which can cause an aortogenic embolic stroke. Case presentation A 70-year-old Asian man presenting 6 months after developing hemoptysis was diagnosed with right upper lobe lung cancer (stage T4N0M0), invading the lower trachea and basal bronchus. Preoperative computed tomography revealed ascending aorta calcification. Right sleeve pneumonectomy was performed using median sternotomy with diseased lung ventilation. The ascending aorta was repeatedly mobilized to adequately expose the tracheobronchial bifurcation. Surgery was uneventful, but he did not recover complete consciousness even after termination of anesthesia. Mild paralysis of both upper extremities was observed. Head magnetic resonance imaging on postoperative day 1 revealed multiple small acute infarctions in the brain, possibly caused by mobilization of the aorta. He received anticoagulation therapy and rehabilitation and was discharged on postoperative day 30. Conclusion The median sternotomy approach in sleeve pneumonectomy enables diseased lung ventilation. However, the possibility of aortogenic embolic stroke should be considered when calcification of the ascending aorta is observed on preoperative computed tomography.

scholarly journals Experience of tracheo-bronchoplastic surgery for lung cancer

2021 ◽  
Vol 20 (4) ◽  
pp. 46-52
Author(s):  
D. N. Pilkevich ◽  
S. A. Dovbnya ◽  
P. M. Kholnyy ◽  
A. S. Tsvirenko
Keyword(s):  
Lung Cancer ◽  
Main Bronchus ◽  
Superior Vena ◽  
Left Lung ◽  
Vena Cava ◽  
Morphological Structure ◽  
Pathological Process ◽  
Vagus Nerves ◽  
The Right ◽  
Functional Operability

Introduction. Currently, surgical treatment of lung cancer is impossible without the use of tracheobronchoplastic operations, which in advanced specialized clinics take up to 5-10% of all radical operations. Material and methods. We conducted a retrospective study including 21 patients with centrally located lung cancer who underwent 22 tracheobronchoplastic radical operations between 2000 and 2021. The operated patients included 18 men and 3 women aged 42 to 67 years (mean age 54.5 ± 12.5 years). The morphological structure of the tumors was represented by carcinoid (2) and squamous cell carcinoma (19). The pathological process was located in the right lung in 16 patients and in the left lung — in five patients. Comorbid status was present in 20 patients. Standard lateral thoracotomy was used in 18 cases, and video-assisted minithoracotomy — in three cases. Extended lymphodissection up to D2 was performed in all surgeries. Combined surgeries included resection of adjacent organs: pericardium (2), unpaired vein (2), superior vena cava (1), diaphragmatic and vagus nerves (1), pleura (1). Results. The average duration of operations was 242.3 minutes (125-345 minutes), the average blood loss was 283.2 ml (50–1000 ml). Complications developed in 5 (22.7%) patients. Mortality was observed in 2 (9.1%) cases. Conclusion. The use of tracheobronchoplastic operations significantly expands the possibilities of thoracic surgery in treatment of lung cancer both due to technical resectability of the tumor at the transition to the main bronchus and trachea and due to functional operability at low respiratory functions and impossibility to perform pneumonectomy.

scholarly journals Left pulmonary artery sling with tracheal stenosis

2018 ◽  
Vol 2 (5) ◽  
Author(s):  
Nguyen Chi Lang ◽  
Nguyen Thi Ngoan ◽  
Nguyen Duc Khoi
Keyword(s):  
Pulmonary Artery ◽  
Main Bronchus ◽  
Left Lung ◽  
Left Pulmonary Artery ◽  
Vertebral Level ◽  
Pulmonary Artery Sling ◽  
Right Pulmonary Artery ◽  
Bridging Bronchus ◽  
Left Pulmonary Artery Sling ◽  
The Right

We present the case of a 4-year-old girl, bronchofiberscopy (scope diameter 2.8mm): one third below oftrachea, which was divided into two orifices. The orifice on the right side was larger and divided into twosuborifices. The left orifice was stenosis and could not pass the bronchoscope. Whole trachea mucosa was redand edema, and could not observe the cartilage ring of trachea. Chest X-ray: infiltration of right lower lobe.Chest CT multiple probes with contrast injection confirmed that: At the sixth to seventh thoracic vertebral level,the left pulmonary artery was arisen from the right pulmonary artery then passed in between the behindtrachea and anterior oesophagus to reach the left lung hilar. And at the fourth to fifth thoracic vertebral level,the right upper bronchus was arisen from trachea and then the trachea was shrunk diameter to reach the leftlung hilar, at the end, the trachea divided 2 bronchi: left main bronchus and “bridging bronchus”. Thatbronchus from left lung hilar returned to the right lung.This patient was diagnosed birth defect: Left pulmonary artery sling with trachea stenosis, type IIA.

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