BACKGROUNDReconstruction of carina, bronchoplasty and arterioplasty are widely used to extend the indication of lung cancer operation. Because these procedures preserve as many healthy lung tissues as possible, their therapeutic effect is better than pneumonectomy in many central lung cancer cases with poor cardiopulmonary function. The aim of this study is to explore the feasibility and indication of extended resection in selected patients with centrally located lung cancer.

METHODSFrom November, 1979 to January, 2003, lobectomy or pneumonectomy combined with extended resection of tracheo-carina, bronchus or vessels were performed in 50 patients with centrally located lung cancer. Tracheo-carinal reconstruction and bronchoplasty were performed in 48 cases, and pulmonary arterioplasty in 2 cases.

RESULTSPostoperative complications occurred in 4 patients (8.0%), and operative death occurred in 2 patients (4.0%). All the 48 patients were followed up from 1 to 10 years. The 1-, 3-, 5- and 10-year survival rate was 89.4% (42/47), 57.1% (20/35), 42.1% (8/19) and 25.0%(2/8) respectively.

CONCLUSIONSExtended pulmonary resection combined with tracheo-carinal reconstruction, bronchoplasty and vascular reconstruction is feasible for selected patients with centrally located lung cancer. It is helpful to prolong the long-term survival of patients with lung cancer.