[Combined resection of the descending aorta for lung cancer with aortic invasion]

Four lung cancer patients underwent left pneumonectomy combined with resection of the descending aorta. Their tumors arose from the superior segment (S6) of the left lower lobe and directly invaded the aorta. Their angles of contact with descending aorta were more than 130 degrees. There were two squamous cell carcinoma, and one each of large cell carcinoma, and adenosquamous carcinoma. In Case 1, the defect of the descending aorta was closed by patch graft using simple aortic cross-clamping. In the other three patients, the aorta was replaced by a 5-7 cm long woven Dacron tube graft under temporary bypass using Anthron tube. Their postoperative courses were uneventful. Although the follow-up period is too short at present, two cases (3 and 4) have been alive without recurrence for five and two months, respectively. The induction chemotherapy followed by extended surgery (Case 4) may become a feasible treatment modality to overcome the poor prognosis in patients with advanced lung cancer invading to the great vessels.