[Surgical treatment for lung cancer invading thoracic aorta]

We experienced three surgical cases of lung cancer invading thoracic aorta, and discussed some problems in order to improve the surgical outcome. In the first case, the patient had a ruptured descending aortic aneurysm into a tumor of left lung. Following urgent graft replacement of descending aorta, left pneumonectomy was carried out, but the patient died of bone marrow dissemination which was probably caused by aspiration of the tumor cells on cardiopulmonary bypass. In the second case, the patient underwent resection of the left upper lobectomy combined with resections of the left subclavian artery and distal aortic arch, but died of perforation of aortic arch due to vascular injury by cross clamp. In the third case, an operation was successfully performed for lung cancer invading the aortic arch. Left upper lobectomy with associated resection of aortic arch, left subclavian and common carotid arteries was performed. Both arteries were replaced with a Gelseal Graft.