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Case report: Complex left-carina resection: three-year single-center experience.

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Left tracheal sleeve pneumonectomy is a complex surgical procedure for tumors near the carina. This study highlights the challenges and successful outcomes of four such cases, emphasizing individualized treatment strategies.

Keywords:
carinacarinal pneumonectomycomplex tracheobronchial resectiontracheal sleeve pneumonectomytracheobronchial angle

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Area of Science:

  • Thoracic surgery
  • Surgical oncology

Background:

  • Tracheal sleeve pneumonectomy enables surgical intervention for carinal and tracheobronchial angle tumors, previously considered inoperable.
  • Left sleeve pneumonectomy is less frequently documented than right-sided procedures due to anatomical complexities.

Observation:

  • Four cases of left tracheal sleeve pneumonectomy (three) and neocarina reconstruction (one) for benign lesions were performed between 2020 and 2023.
  • All procedures were conducted via median sternotomy without cardiopulmonary bypass.
  • Patients experienced a median hospital stay of 21.5 days, followed by intensive physiotherapy for functional recovery.

Findings:

  • The study reports zero 30-day mortality for these challenging left sleeve pneumonectomies.
  • Despite complexities, the surgical approach was feasible without requiring cardiovascular support.

Implications:

  • The findings suggest that left tracheal sleeve pneumonectomy can be performed safely, even in complex cases.
  • Further research is needed to establish standardized treatment protocols for this rare procedure.
  • Individualized patient assessment remains critical for successful surgical outcomes.