Consecutive left lower sleeve lobectomy and left S3 segmentectomy for a patient with node-negative double lung cancer

A 74-year-old-man visited our hospital because of a dry cough. A chest radiograph showed a nodular shadow measuring 2.0 cm diameter in the left S3 segment and a tumor shadow measuring 3.5 cm diameter in the left S6 segment; no mediastinal lymph node enlargement was observed. The bronchoscopic findings revealed direct invasion of the tumor into the spur of the left B6 branch, but no abnormal findings were found in the upper bronchus. An endobronchial biopsy revealed squamous cell carcinoma in a left B6 biopsy specimen and adenocarcinoma in the left S3 lung biopsy specimen. The patient's lung function was not good, and an arterial blood gas analysis was Po2 69.3mmHg and PCO2 48.5 mmHg. We performed left lower sleeve lobectomy and left S3 segmentectomy simultaneously. He was discharged uneventfully on the 14th day after the operation, and he has since been doing fine without lung caner recurrence for 3 years after surgery.