Results of carinal resection for bronchogenic carcinoma

Fifteen patients underwent carinal resection for lung cancer during the years of 1957 through 1993. All were males with ages ranging from 40 to 81 (mean 60.1) years old. Cell Types of the cancer were squamous cell carcinoma in 12 cases, adenocarcinoma in 2 and small cell carcinoma in one. In 14 of 15 cases there was cancerous invasion into the tracheal carina (T4) and one had no involvement of the carina (T3). Four patients had no lymph node metastasis (N0), 2 had hilar node metastasis (N1), 8 had ipsilateral mediastinal node metastasis (N2) and one had contralateral mediastinal node metastasis (N3). Operative procedures for carino-plasty were sleeve pneumonectomy in 3 cases, pneumonectomy with wedge resection of the carina in 3, sleeve resection of the carina followed by reconstruction of the carina (Montage type) in 8, and carinal resection with reconstruction of the one-stoma type in one. Two patients died within one month due to pneumonia or renal failure (13.3%). Postoperative complications occurred in 14 cases and bronchorrhea (n = 8), anastomotic stenosis (n = 5) and pneumonia (n = 4) were frequent. Excluding 2 operative deaths, 8 cases died from 2 to 37 months after operation (mean 13.1 months) and 5 are alive from 10 to 24 months without recurrences. Patients with squamous cell carcinoma with N0 or N1 had better prognosis.