New era of “resection of the carina and lower trachea”

Ujiie, Hideki; Yasufuku, Kazuhiro

doi:10.21037/jtd.2017.11.88

Cited by 9 publications

(9 citation statements)

References 25 publications

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“…Fluoroscopy can also be used to assess the correct positioning of the single lumen canula, but it could be more impractical and will require constant mobilization and interruption of the procedure to accommodate the equipment if misplacement occurs during surgery. Veno-arterial ECMO is an option in cases where the patient has preexisting lung parenchymal diseases (16), hemodynamic support might be necessary during lung resection, considerable cardiac retraction could be necessary for exposure (25) or during intense emergency situations in which the hemodynamic conditions of the patient are already compromised (26).…”

Section: Anesthesiologic Considerationsmentioning

confidence: 99%

Tracheal and carinal resections in the treatment of non-small cell lung cancer: a trend to a minimally invasive approach

Guido-Guerrero¹,

Bolaños-Cubillo²,

García-Pérez³

et al. 2021

Curr Chall Thorac Surg

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Surgical treatment for non-small cell lung cancer (NSCLC) involving trachea and carina is one of the most infrequent and challenging procedures for a thoracic surgeon, requiring careful preoperative assessment, high level management of the airway, advanced surgical technique and appropriate postoperative care. Carinal and tracheal resections with lung sparing, and carinal sleeve pneumonectomy are part of these complex techniques, with a variable rate of morbidity and mortality. To prevent complications, the most important aspect of the technique is for reconstruction to be performed without tension and with a good blood supply. If a complication is suspected, it must be diagnosed at an early stage, and the problem must be handled aggressively to avoid further progression. The majority of cases are performed with an open approach, but under the care of surgeons and anesthesiologists experienced in minimally invasive thoracic procedures, with advanced airway management skills, in high volume referral centers, these procedures can be performed safely with video-assisted thoracic surgery to obtain good postoperative results. In recent years, with the rapid development of uniportal video assisted thoracic surgery (VATS), this approach resulted in shorter postoperative stays, less postoperative pain and faster recovery after surgery, maintaining oncological principles, becoming an excellent alternative for these difficult cases. This article aims to review the specific considerations that involve this kind of tumors, surgical technique and anesthesiology options, and the recent shift to a minimally invasive approach.

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Section: Anesthesiologic Considerationsmentioning

confidence: 99%

Tracheal and carinal resections in the treatment of non-small cell lung cancer: a trend to a minimally invasive approach

Guido-Guerrero¹,

Bolaños-Cubillo²,

García-Pérez³

et al. 2021

Curr Chall Thorac Surg

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“…Petersen and Ujiie also suggest that there are other additional important limitations in the case of VATS carinal resection: the difficulty to manage an optimal intraoperative 2D view (the adjustment of the monitor view during the operation), the high risk to achieve an insufficient oncological resection and the complexity to plan a good arrangement with the anesthesiologist during airway resection (proper airway management during the reconstruction) (26,27).…”

Section: Editorial Commentarymentioning

confidence: 99%

Editorial on: are we achieving ultimative limits of the minimally invasive thoracic surgery?

Girotti¹

2021

Transl Lung Cancer Res

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“…On the other hand, placing interrupted sutures using a VATS approach can be more complex and time-consuming than using a running suture. The use of continuous running sutures provides a better operative view and has been proven safe and effective in VATS (45).…”

Section: Carinal and Tracheal Resectionmentioning

confidence: 99%

“…The ECMO provides a tubeless operation field in a TRR, so veno-venous (V-V) ECMO could be useful for uniportal VATS and airway surgery. It is also a tool for management of adequate oxygenation in the context of an emergency airway surgery, when it is impossible to ventilate the patient (45,49). The disadvantages of using ECMO involve a more invasive approach that requires vascular cannulation and the amount of blood loss in the circuit once the patient is decannulated.…”

Section: Carinal and Tracheal Resectionmentioning

confidence: 99%

Single-port video-assisted thoracic surgery (VATS)—advanced procedures & update

Guido-Guerrero¹,

Bolaños-Cubillo²,

González-Rivas³

2018

J. Thorac. Dis.

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The uniportal approach for major pulmonary resections began in 2010, with the first case being reported by D González-Rivas and colleagues in La Coruña, Spain. Since then, in different countries, thoracic surgeons had been performing hundreds of cases, with more advanced and complex procedures. Nowadays, there are reports of uniportal tracheal resection and reconstruction, carinal resection, bronchoplastic procedures, lobectomies with chest wall excision, and vascular reconstruction with optimal outcomes. The development of technologies and the potential benefits of a direct view, anatomic instrumentation, better cosmesis, and, potentially, less postoperative pain have led uniportal video-assisted thoracic surgery to grow exponentially worldwide.

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New era of “resection of the carina and lower trachea”

Cited by 9 publications

References 25 publications

Tracheal and carinal resections in the treatment of non-small cell lung cancer: a trend to a minimally invasive approach

Tracheal and carinal resections in the treatment of non-small cell lung cancer: a trend to a minimally invasive approach

Editorial on: are we achieving ultimative limits of the minimally invasive thoracic surgery?

Single-port video-assisted thoracic surgery (VATS)—advanced procedures & update

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