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Lung sparing left secondary carina resection for low-grade tumors: a single-center study

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Abstract

Left-side secondary carina resection and reconstruction is a rare, complex procedure, performed just in a few specialized centers in a restricted group of patients. Few studies describe this technique and report its short and long-term results. We reviewed our experience to evaluate the perioperative and short-term outcomes of a very demanding surgery. We retrospectively collected the information of all the patients who underwent secondary carina resection and reconstruction for low-grade malignant bronchial tumors at our center. Between January 2012 and September 2018, 23 patients received surgery for low-grade malignant bronchial tumors. In all patients, a secondary carina resection and reconstruction with total lung parenchymal preservation was performed. The mean age was 44.5 ± 12.2 years. Pathologies included adenoid cystic carcinoma in ten patients, carcinoid in 7 (6 typical and 1 atypical), mucoepidermoid carcinoma in 4, myoepithelioma in 1 and inflammatory myofibroblastic tumor in 1. The median length of the resected bronchus was 25 mm (range 15–50 mm). Three patients (13%) had, at least, one postoperative complication with no deaths. Two patients had lymph node metastases and eight had positive margins. Nine patients received adjuvant therapy. Follow-up ranged from 13 to 96 months, all patients are currently alive and free of recurrence. Resection and reconstruction of the left secondary carina with preservation of the lung parenchyma can be performed safely in anatomically and oncologically appropriate patients, providing good short-term results when combined with adjuvant therapies.

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Author notes

  1. Alessio Campisi and Liang Chen contributed equally to this paper.

Authors and Affiliations

  1. Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, 241 Huai Hai Road, Shanghai, 200030, China

    Alessio Campisi, Liang Chen, Zhexin Wang, Heng Zhao & Feng Yao

  2. Thoracic Surgery Unit, Department of Thoracic Diseases, University of Bologna, G.B. Morgagni-L. Pierantoni Hospital, 34 Carlo Forlanini Street, 47121, Forlì, Italy

    Alessio Campisi, Angelo Paolo Ciarrocchi & Franco Stella

  3. Division of Thoracic Surgery, Department of Cardiothoracic Surgery and Vascular Sciences, Padua University Hospital, University of Padua, Via Giustiniani 1, Padua, PD, Italy

    Andrea Dell’Amore

Authors
  1. Alessio Campisi
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  2. Liang Chen
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  3. Andrea Dell’Amore
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  4. Angelo Paolo Ciarrocchi
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  5. Zhexin Wang
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  6. Heng Zhao
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  7. Franco Stella
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  8. Feng Yao
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Contributions

Conceptualization: FY, LC, HZ. Data curation: AC, LC, ZW, FY. Formal analysis: AC, LC, FY. Funding acquisition: None. Investigation: AC, LC, FY. Methodology: AC, LC, FY. Project administration: FS, HZ, FY. Resources: None. Softwares: AC, LC, FY. Supervision: ADA, FS, HZ. Validation: ADA, FS, HZ. Visualization: AC, LC, FY. Writing—original draft: AC, APC, LC, FY. Writing—review and editing: ADA, ZW, FY.

Corresponding author

Correspondence to Feng Yao.

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All authors declare that they have no conflict of interest.

Ethical approval and informed consent

The study was approved by the institutional review board of Shanghai Chest Hospital (the ID approval number was not produced) and written informed consent was obtained from all patients. All figures and tables are original and have not been published before.

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Supplementary Information

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Supplementary file1 (MP4 73837 kb) Video.1: the technique of left secondary carina resection and reconstruction

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Campisi, A., Chen, L., Dell’Amore, A. et al. Lung sparing left secondary carina resection for low-grade tumors: a single-center study. Updates Surg 73, 2363–2368 (2021). https://doi.org/10.1007/s13304-021-01127-y

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  • DOI: https://doi.org/10.1007/s13304-021-01127-y

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