Carinal resection and reconstruction in thoracic malignancies

Abstract

Malignant tumors involving the carina can be controlled with carinal surgery with acceptable mortality and morbidity. Patients with thoracic malignancy involving the carina should be considered as surgical candidate based on disease extent and functional status.

Carinal resection and sleeve pneumonectomy

“…Neoplasms involving the carina and/or distal trachea without systemic or lymphatic metastases are uncommon but not rare (1,2). Most of these patients were diagnosed at an advanced stage, and were likely to be no longer candidates for surgical resection (1).…”

“…Most of these patients were diagnosed at an advanced stage, and were likely to be no longer candidates for surgical resection (1). On the other hand, patients with limited involvement of the carina or distal trachea can still be considered for extended surgical resection with airway reconstruction (1).…”

Tracheal Y-stent Implantation For Stenosis After Carina Reconstruction Surgery

“…In this case, expandable metallic stent (EMS) was used, granulation tissue developed during follow-up and the patient died at 24 months. Among the 30 cases presented by Shin et al (2), three cases developed stenosis and stent was implemented in two. However, stent type and duration was not reported in the aforementioned study.…”

“…In these cases, surgical excision of the tumor has acceptable mortality and morbidity rates and has been shown to improve survival in carefully selected patients (6). Resectable primary non-www.respircase.com small cell tumors of distal trachea and tracheal carina are rare which require experienced surgeon and anesthesiologist (2). In a case series published by Shin et al (6), younger patients with improved physical conditions were found to be more suitable for surgery.…”

Minimally invasive resection and reconstruction of the intrathoracic trachea and carina

“…Despite of central airway surgery being usually more complex and time-consuming procedures, the additional cross-field ventilation is a successful option in different central tracheoand carinoplasties, and is therefore used in the vast majority (12,13). One of the disadvantages of this technique is, that the cross-field tube can sometimes obstruct the view of the reconstruction site, thus periodical retraction of the tube may sometimes be necessary when performing airway anastomosis in order to improve exposure (3).…”