Left secondary carinal resection and reconstruction for low-grade bronchial malignanciesCentral MessagePerspective

Objectives: A rare and complex procedure, total lung sparing left secondary carinal resection and reconstruction is only performed in a few specialized centers in a restricted group of patients. We reviewed our experience to evaluate its safety. Methods: Patients who underwent left secondary carinal...

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Main Authors: Liang Chen, MD, Alessio Campisi, MD, Zhexin Wang, MD, Andrea Dell'Amore, MD, Angelo Paolo Ciarrocchi, MD, Heng Zhao, MD, Franco Stella, MD, PhD, Feng Yao, MD
Format: Article
Language:English
Published: Elsevier 2021-08-01
Series:JTCVS Techniques
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666250721003795
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Summary:Objectives: A rare and complex procedure, total lung sparing left secondary carinal resection and reconstruction is only performed in a few specialized centers in a restricted group of patients. We reviewed our experience to evaluate its safety. Methods: Patients who underwent left secondary carinal resection and reconstruction with complete lung parenchymal preservation for low-grade bronchial malignancies at the Shanghai Chest Hospital and the Padua University Hospital were retrospectively reviewed. Clinicopathologic factors and perioperative outcomes were analyzed. Results: Thirty patients underwent the procedure between July 2012 and July 2019 (mean age, 42.9 years). No operative mortality occurred and postoperative complications developed in 4 patients (13.3%), including pneumonia (n = 3 [10.0%]), subcutaneous emphysema (n = 2 [6.7%]), and prolonged air leak (n = 2 [6.7%]). Pathologies included adenoid cystic carcinoma (n = 11), mucoepidermoid carcinoma (n = 6), carcinoid tumors (n = 9 [8 typical and 1 atypical subtypes]), inflammatory myofibroblastic tumor (n = 3), and myoepithelioma (n = 1). The margins were positive in 8 patients (26.7%), whereas 2 patients (6.7%) had positive lymph nodes. Adjuvant therapies were performed postoperatively, including chemoradiotherapy for positive lymph nodes and radiotherapy for positive margins. Conclusions: Total lung sparing left secondary carinal resection and reconstruction can be performed safely in well-selected and oncologically appropriate patients with low-grade bronchial malignancies.
ISSN:2666-2507