We report two patients who underwent carinal resection and reconstruction for advanced lung cancer under veno-venous bypass. The bypass system consisted of a centrifugal pump and a hollow-fiber membrane oxygenator, and was established by percutaneous insertion of cannulas through the femoral veins using the Seldinger technique. This respiratory support system under veno-venous bypass was safe and useful for carinal reconstruction, providing a good visual field and adequate oxygenation. Although other standard accepted ventilation techniques can be used for carinal resection, veno-venous bypass is an alternative adjunct in cases involving difficult carinal reconstruction.
Pulmonary amyloidoma is a rare disease which is usually found incidentally on chest radiographs in asymptomatic, elderly people. Amyloid nodules may be solitary or much more commonly multiple. There have been many reports of radiological findings of pulmonary amyloidosis; however, those have not been characteristic. We report the findings on CT and MRI of a proven primary pulmonary amyloidoma in an asymptomatic 76-year-old woman. The low intensity of the lesion on T2-weighted images may be useful in the differential diagnosis from bronchogenic carcinoma.
We report data on two patients with advanced non-small-cell lung cancer invading the aorta, who underwent successful radical operation under cardiopulmonary bypass. One patient (case 1) has been followed up for more than 16 months after the operation without any evidence of local recurrence of the tumor or distal metastases. Although this surgical intervention for an advanced lung cancer invading the aortic wall might be a challenge, we believe that such an aggressive surgical intervention is justified if cure is anticipated.
Although surgical intervention for advanced lung cancer invading the aortic wall is challenging, we successfully carried out such radical surgery under cardiopulmonary bypass as previously reported in this journal. One patient has now been followed for more than 5 years after the operation, so that we conclude if there is no evidence of metastatic cancer in selected patients then complete resection should be attempted using circulatory support, with the hope of an occasional cure.
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