Extended operation for lung cancer invading the aortic arch and superior vena cava

Extended operation for lung cancer and mediastinal carcinoma involving the aortic arch or superior vena cava was performed in six patients. In three patients with lung cancer invading the right side of the mediastinum, sleeve pneumonectomy (two patients) or sleeve lobectomy was followed by resection...

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Bibliographic Details
Published in:The Journal of thoracic and cardiovascular surgery 1989-03, Vol.97 (3), p.428-433
Main Authors: Nakahara, K, Ohno, K, Mastumura, A, Hirose, H, Mastuda, H, Nakano, S, Shirakura, R, Kawashima, Y
Format: Article
Language:English
Subjects:
Adult
Aorta, Thoracic - pathology
Aorta, Thoracic - surgery
Biological and medical sciences
Blood Vessel Prosthesis
Bronchi - pathology
Bronchial Neoplasms - pathology
Bronchial Neoplasms - surgery
Female
Humans
Lung Neoplasms - pathology
Lung Neoplasms - surgery
Male
Mediastinal Neoplasms - pathology
Mediastinum - pathology
Medical sciences
Methods
Middle Aged
Neoplasm Invasiveness
Pneumology
Pneumonectomy - methods
Tumors of the respiratory system and mediastinum
Vascular Diseases - pathology
Vascular Diseases - surgery
Vena Cava, Superior - pathology
Vena Cava, Superior - surgery
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Summary:Extended operation for lung cancer and mediastinal carcinoma involving the aortic arch or superior vena cava was performed in six patients. In three patients with lung cancer invading the right side of the mediastinum, sleeve pneumonectomy (two patients) or sleeve lobectomy was followed by resection and reconstruction of the superior vena cava with ringed polytetrafluoroethylene grafts. One patient with squamous cell carcinoma and T4 N1 M0 disease was alive and free of disease more than 34 months after the operation. The other patients with adenocarcinoma (T4 N1 M0) and adenosquamous cell carcinoma (T4 N2 M0) died 18 and 5 months after the operation of systemic metastases. In two patients with invasion of lung cancer into the left side of the mediastinum, resection and reconstruction of the aortic arch and left common carotid artery were performed by a femoro-femoral bypass. These patients had adenocarcinoma (T4 N2 M0) and large cell carcinoma (T4 N1 M0) and died of systemic metastases and bleeding during reoperation 12 and 4 months after the initial operation. In one patient with mediastinal squamous cell carcinoma, resection and reconstruction of the aortic arch and left subclavian artery were performed by application of a temporary bypass graft between the ascending and descending aorta. This patient was alive and free of disease more than 17 months after the operation.
ISSN:0022-5223
1097-685X
DOI:10.1016/s0022-5223(19)34582-9