Extended sleeve pneumonectomy with cardiac resection is technically feasible for advanced lung cancer, though long-term survival may be limited by metastatic disease.
Metastatic coronary infiltration risks late MI after resection; leaves open long-term benefit of extended sleeve pneumonectomy in advanced lung cancer.
Extended sleeve pneumonectomy including removal of the superior vena cava, right atrium and parts of left atrium on cardiopulmonary bypass was successfully performed in a 40-year-old man. The tumour was histologically proven a T4 N1 stage with margins free from tumour. Adjuvant radiochemotherapy was administered postoperatively on an outpatient base. The patient did well for 7 months then he died from myocardial infarction due to metastatic infiltration of the right coronary artery. Other metastatic deposits were not found at autopsy. More data from extended pulmonary resections are required to demonstrate a benefit.
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Ernst et al. (1999) studied this question.
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