A Case in Which Left Pneumonectomy Was Required in an Octogenarian with an Oncological Emergency due to Locally Advanced Primary Lung Cancer

Background. The study objective is to evaluate the efficacy of pump operations in locally advanced IIIB (T4N0-1M0) lung cancer and other thoracic malignancies and the results of treatment. Materials and methods. In the period 2003–2011, 6 patients (pts) with locally advanced thoracic malignancies underwent surgery in the Center of Cardiac Surgery of Vilnius University Hospital Santariskiu Clinics (VUH SC). Patients’ characteristics and stage: lung cancer – 3 pts (50.0%), stage IIIB (T4N0-1M0), sarcoma of mediastinum – 2 pts (33.3%), fibrous tumour of mediastinum – 1 pt (16.7%). Patients according to morphology: squamous cell carcinoma – 3 pts (50.0%), neuroangiosarcoma – 1 pt (16.7%), neurosarcoma – 1 pt (16.7%), solitary fibrous tumour – 1 pt (16.7%). After surgery patients received adjuvant treatment: 3 pts with lung cancer received 4 cycles of chemotherapy Gemcitabine with cisplatinum, 2 pts with angiosarcoma received radiation therapy 66 Gy and 6 cycles of chemotherapy Ifosfamide. Results. We performed pneumonectomy with left atrium resection – 2 pts (33.3%), left pneumonectomy with aorta resection – 1 pt (16.7%), left atrium resection with left upper lobectomy – 1 pt (16.7%), mediastinum resection with chest wall reconstruction – 1 pt (16.7%), left pneumonectomy – 1 pt (16.7%). We had no complications after pump operations. Median survival of patients with lung cancer was 2.5 ± 0.5 years, with angiosarcoma 3.5 ± 1.0 years. Five-year survival was 25%. Conclusions. 1. Pump operations are safe and possible in locally advanced thoracic malignancies. 2. Pump operations and adjuvant treatment may prolong median survival in IIIB (T4N0-1M0) lung cancer patients by 2.5 ± 0.5 years and in angiosarcoma patients by 3.5 ± 1.0 years.

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Left pneumonectomy for primary lung cancer with Trousseau’s syndrome

BMJ Case Reports ◽

10.1136/bcr-2020-240927 ◽

2021 ◽

Vol 14 (3) ◽

pp. e240927

Author(s):

Hideomi Ichinokawa ◽

Yusuke Nagasaki ◽

Yutaro Koike ◽

Kenji Suzuki

Keyword(s):

Lung Cancer ◽

Pathological Condition ◽

Tumour Size ◽

Primary Lung Cancer ◽

Advanced Lung Cancer ◽

Cerebral Stroke ◽

Malignant Tumours ◽

Stage Iiia ◽

Trousseau’S Syndrome ◽

Left Pneumonectomy

Trousseau’s syndrome is a paraneoplastic syndrome and a pathological condition that causes cerebral stroke symptoms due to hypercoagulation associated with malignant tumours. There have been many cases of advanced lung cancer, but few reports have described surgery for lung cancer with Trousseau’s syndrome. We encountered a 76-year-old man suspected of having Trousseau’s syndrome associated with lung cancer. He was transferred to our hospital on the second day after the onset. After admission, he was treated with heparin and edaravone, and his condition improved. On the 12th day after the onset, we performed left pneumonectomy and lymph node dissection (ND2a-2). The final pathological results were adenocarcinoma, pathological stage was T4 (tumour size: 77 mm, pulmonary artery invasion) N1(#11, #12u) M0, stage IIIA. He has been recurrence free for 23 months since the surgery. In the future, we need to follow his condition carefully.

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Carinal Resection and Reconstruction for Locally Advanced Primary Lung Cancer: Institutional Report

ISRN Pulmonology ◽

10.1155/2014/692590 ◽

2014 ◽

Vol 2014 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Yuji Matsumura ◽

Muneo Minowa ◽

Osamu Araki ◽

Yoko Karube ◽

Masayuki Chida

Keyword(s):

Lung Cancer ◽

Locally Advanced ◽

Primary Lung Cancer ◽

Advanced Lung Cancer ◽

Anastomotic Site ◽

Operative Death ◽

Carinal Resection ◽

Significant Difference ◽

Locally Advanced Lung Cancer ◽

The One

Carinal resection and reconstruction for lung cancer, termed carinaplasty, is a rare operation, and the procedure remains challenging and few reports have been presented. We analyzed complications, local control, and manner of recurrence in patients who underwent a carinaplasty and compared the results to those who underwent an ordinary bronchoplasty. Among 766 patients who underwent surgery for primary lung cancer at our institutions, 82 bronchoplasty procedures were performed, while 6 of those who received a bronchoplasty underwent a carinaplasty. Three of 6 patients who received a carinaplasty underwent the montage method, and other 3 patients underwent the one-stoma method. There were no operative deaths in patients who underwent a carinaplasty, while there was 1 operative death in the group of patients who underwent an ordinary bronchoplasty. Complications in the anastomotic site were observed in 33% in the carinaplasty group and 5.3% in the ordinary bronchoplasty group (P=0.011). There was no significant difference in regard to local recurrence between the groups (P=0.620). In conclusion, our results show that a carinaplasty is a technically demanding but useful procedure to avoid a pneumonectomy in patients with locally advanced lung cancer.

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