Lung autotransplantation technique for treating central lung cancer of upper lobe

To assess the feasibility of applying lung autotransplantation technique in the treatment of central lung cancer of the upper lobe.

Two patients underwent double-sleeve right upper and middle bilobectomy. Because the length of resected bronchus or pulmonary artery involved by tumor was too long to perform tension-free anastomosis, we had to transplant the lower lobar vein into the proximal stump of the upper lobar vein. Another two patients underwent pneumonectomy firstly, because we could not perform sleeve lobectomy in suit as the tumor extended through the oblique fissure to the margin of the lower lobe. Subsequently, we resected the tumor parts at a separate table, and replanted the preservable part of the lung into the chest.

Being followed up to December 1999, the patient 1, 3 and 4 had been alive with tumor free for 31, 18 and 13 months. The patient 1 and 3 had a good living quality but the patient 4 had a very poor activity. The patient 4 received resection of the replanted lung for pulmonary artery bronchus pleural fistula on the 42nd day after operation. The second patient died of tension pneumothorax associated with bronchopleural fistula on the 19th day after operation.

Lung autotransplantation is an alternative technique for pulmonary preservation in patients with stage III central lung cancer of the upper lobe whose cardiopulmonary function is too poor to undergo pneumonectomy.