Anatomical lung resection for left lung cancer after thoracic aortic replacement

After thoracic aortic replacement, extensive adhesions are expected to develop between the prosthesis and the lung. There have been no definitive reports on anatomical lung resection performed in patients with left lung cancer after thoracic aortic replacement. Herein, we report a series of five such cases. Our findings showed that severe adhesions were encountered after aortic arch and descending aortic replacement, but not after ascending aortic replacement. We think that these adhesions started developing in the early postoperative period and were particularly severe in the case of left upper lobe lung cancer after arch replacement. However, anatomical lobectomy and systematic lymph node dissection could still be performed safely by devising a surgical technique. In addition, there was a possibility that a new aortic aneurysm may have occurred at the time of surgery. Therefore, it is important to perform a thorough preoperative evaluation and coordinate with the cardiovascular surgery department.