Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2018 Jul;10(7):E584-E586.
doi: 10.21037/jtd.2018.06.39.

Combined approach using uniportal video-assisted thoracoscopic surgery in left tracheal sleeve pneumonectomy

Allan Aim  1 , Ingemar Almre  1 , Tõnu Vanakesa  1
Affiliations
Case Reports

Combined approach using uniportal video-assisted thoracoscopic surgery in left tracheal sleeve pneumonectomy

Allan Aim et al. J Thorac Dis. 2018 Jul.

Abstract

Left tracheal sleeve pneumonectomy is rare and challenging surgical procedure with high postoperative complication and mortality rates. We describe the least invasive single-stage surgical approach using uniportal video-assisted thoracoscopic surgery (VATS) currently successfully applied for a left centrally located bronchogenic carcinoma with tracheal involvement. This case shows how uniportal VATS can be effectively used in challenging cases for reducing invasiveness without compromising patient safety nor oncological principles of complete surgical resection.

Keywords: Lung cancer; pneumonectomy; trachea; video-assisted thoracoscopic surgery (VATS).

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Preoperative diagnostics. (A) Computed tomography scan (CT scan) shows bronchogenic carcinoma of the left main bronchus extending into the lower part of the trachea (white arrow); (B) CT scan: synchronous bronchogenic carcinoma originating from the left lower lobe bronchus (white arrow); (C) bronchoscopic appearance: obstructive tumor in left main bronchus.
Figure 2
Figure 2
Surgical procedure and outcome. (A) Intraoperative image shows the cross-field intubation of left main bronchus and anastomosis between trachea (white arrow) and right main bronchus (two white arrows) reinforced with vascularized intercostal muscle flap (asterisk); (B) postoperative image shows the chest drain inserted through the left utility thoracotomy incision for the uniportal VATS pneumonectomy; (C) bronchoscopic appearance: tracheobronchial anastomosis on the 7th postoperative day. VATS, video-assisted thoracoscopic surgery.
Figure 3
Figure 3
Resected specimen: left lung with two lower tracheal rings (white arrow) including lower lobe centrally located tumor (two white arrows).
See this image and copyright information in PMC

References

    1. Weder W, Inci I. Carinal resection and sleeve pneumonectomy. Thorac Surg Clin 2014;24:77-83. 10.1016/j.thorsurg.2013.10.004 - DOI - PubMed
    1. Rea F, Marulli G, Schiavon M, et al. Tracheal sleeve pneumonectomy for non small cell lung cancer (NSCLC): short and long-term results in a single institution. Lung Cancer 2008;61:202-8. 10.1016/j.lungcan.2007.12.015 - DOI - PubMed
    1. Ai B, Liao Y, Zhang Z, et al. Single-stage bilateral thoracic surgery via a combined VATS and open approach for left central bronchogenic carcinoma with carinal invasion: report of two cases. J Cardiothorac Surg 2015;10:76. 10.1186/s13019-015-0276-z - DOI - PMC - PubMed
    1. Harris CG, James RS, Tian DH, et al. Systematic review and meta-analysis of uniportal versus multiportal video-assisted thoracoscopic lobectomy for lung cancer. Ann Cardiothorac Surg 2016;5:76-84. 10.21037/acs.2016.03.17 - DOI - PMC - PubMed
    1. Gonzalez-Rivas D, Yang Y, Stupnik T, et al. Uniportal video-assisted thoracoscopic bronchovascular, tracheal and carinal sleeve resections†. Eur J Cardiothorac Surg 2016;49 Suppl 1:i6-16. - PubMed

Publication types

LinkOut - more resources