An alternative, non-sleeve technique for reconstruction of main and secondary carina

A non-sleeve resection technique was used in 15 patients requiring reconstruction of the main or secondary carina because of malignant invasion. The technique, which can be employed only in cases of partial carina invasion, utilizes healthy bronchial tissue to cover the defect after resection. The operations comprised right pneumonectomy with reconstruction of the main carina (11 cases), left lower lobectomy with reconstruction of the secondary carina (2) and right upper lobectomy (1) and right lower bilobectomy (1), both with reconstruction of the upper lobe carina. There were no intraoperative deaths or major complications, except for one bronchopleural fistula. Six patients died after 20-month to 4-year observation, six are alive (2 with and 4 without malignant disease) after 6 months to 3 years, and three have survived for more than 5 years. These initial results that our "modified sleeve resection technique" is a reliable option when the carina is partially invaded.