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Carinal resection.
Lorenzo Spaggiari1, Francesco Petrella, Domenico Galetta
1Division of Thoracic Surgery, European Institute of Oncology, Milan, Italy.
Multimedia Manual of Cardiothoracic Surgery : MMCTS
|January 14, 2014
Summary
Carinal resection, a complex airway surgery, shows promising 5-year survival rates of 50% in lung cancer patients with carinal infiltration. Multimodality treatment approaches are still debated.
Area of Science:
- Thoracic Surgery
- Surgical Oncology
- Pulmonology
Background:
- Carinal resection involves the tracheo-bronchial bifurcation, posing significant surgical challenges due to lesion variability.
- Primary indications include tumors of the carina/distal trachea and bronchogenic carcinoma with carinal involvement.
Purpose of the Study:
- To review the historical and current approaches to carinal resection and reconstruction.
- To evaluate the outcomes and challenges associated with carinal resection for neoplastic involvement.
Main Methods:
- Review of experimental and clinical approaches over the past 50 years.
- Analysis of recent series reporting on carinal resection outcomes.
Main Results:
- Despite technical and oncological difficulties, encouraging results have been reported.
- A 5-year survival rate of 50% was observed in pN0 patients with lung cancer carinal infiltration.
Conclusions:
- Carinal resection is a challenging but feasible procedure for specific oncological indications.
- Debates continue regarding optimal multimodality treatment, including induction therapy and the role of chemoradiation versus surgical options.
