[Treatment Policy for Avoiding Pneumonectomy Regarding the Locally Advanced Lung Cancers]

The problem of pneumonectomy may result from an elimination of the extensive pulmonary vascular bed as a unit. Therefore this paper has indicated that 10 cases with the locally advanced lung cancers had been treated with some parenchymal sparing procedures including chemotherapy in order to avoid pneumonectomy. Six cases with preoperative chemotherapy were performed sleeve lobectomy in 3 cases, tangential pulmonary artery(PA) resection in 2, and left atrium partial resection in 1. One case with irradiation in vain was done sleeve LLL+lS4+5segmentectomy. Three cases without pre-treatment were done tangential PA resection in 2 cases, sleeve lobectomy in 1. Outcome was that there were no perioperative mortality and 7 cases achieved long-term survival, however, 2 cases died of relapse, and one died of pneumonia. On surgical technique U-shape mattress interrupted suture for bronchoplasty and tangential PA resection were proved very useful procedures.