Tracheal Carinal Reconstruction and Bronchovasculoplasty in Central Type Bronchogenic Carcinoma

Background and objective Because radical resection for lung cancer invading the initial borderline of different lobes and carina is difficult, we tried to analyse the variables of successful tracheal carinoplasty and bronchovasculoplasty to discover a proper approach for appropriate early and long term results. Methods Of 1 399 lung resections for primary lung cancer performed in our hospital from April 1985 to December 2006, 133 underwent bronchoplastic surgeries, including 15 carinoplasty cases and 118 sleeve lobectomy (SL) cases, and 118 pneumoectomy (PN) cases were compared at the same time. Results Complications occurred in 18 cases, with no operative related mortality. For all patients, the 1 year, 3 year, and 5 year survival rates were 79.8%, 56.7% and 31.2%, respectively. The 5 year survival rate by cancer stage was 69.2% for Ib, 40.6% for IIb, 19.6% for IIIa, and 16.6% for IIIa (N2). Conclusion Selection of cases, clearance of lymph nodes, disposal of the bronchus and pulmonary vessel and replacement or restoration of the superior vena cava are the main factors influencing prognosis.