The “Kergin pneumonectomy”

Abstract

Out of a series of 211 stage III (A and B) lung cancers radically resected with routine lymphadenectomy from 1971 to 1987, a total of 11 were squamous cell carcinomas invading the right main bronchus and lateral portion of the trachea. These patients were managed using a particular technique that we have always arbitrarily called, "Kergin pneumonectomy," after the Toronto surgeon who described it in 1952. These patients, today, are staged III B. There was no operative mortality and only 2 minor complications. Two patients survived 3 years and 1 is alive and free of disease 7 years from surgery. This technique should be considered before embarking on more perilous surgery such as "sleeve pneumonectomy," a procedure which still carries high mortality and morbidity rates and requires special equipment and intensive postoperative care.

Left-sided modified Kergin carinoplasty as an alternative to carinal resection for centrally located non–small cell lung cancer pretreated by radiochemotherapy

“…The technique was applied to 11 patients, with no mortality and uneventful healing of the airway in all cases. 5 We modified this concept and adapted it to a patient with centrally located NSCLC, originating at the inferior part of the left main stem bronchus and extending to the inferior part of the carina and of the contralateral main stem bronchus. In this situation, the pedicled airway flap was created from the tumor-free cranial circumference of the left main stem bronchus during left pneumonectomy.…”

“…[1][2][3] This holds especially true for left-sided carinal resection 1 and resections performed for centrally located tumors after neoadjuvant treatment. 3 We designed a modified left-sided Kergin procedure 4,5 to avoid a left-sided carinal pneumonectomy after neoadjuvant radiochemotherapy for centrally located non-small cell cancer (NSCLC) of the left main stem bronchus with carinal involvement.…”