Key result
Endoaortic stent implantation followed by partial lung and aortic wall resection reduces perioperative mortality and morbidity in T4 lung carcinoma compared to traditional cardiopulmonary bypass.
Why the study?
What are the indications and surgical procedures for managing T4 lung carcinoma with infiltration of the thoracic aorta?
What are the indications and surgical procedures for managing T4 lung carcinoma with infiltration of the thoracic aorta?
Endoaortic stent implantation prior to resection of T4 lung carcinoma infiltrating the aorta offers a safer alternative to cardiopulmonary bypass, reducing perioperative morbidity and mortality.
Lung carcinomas infiltrate the aorta mostly on the left side and are altogether rare. As an initial step, complete staging is performed and the results are evaluated in an interdisciplinary tumor board. If the patient's general condition including cardiopulmonary reserves is sufficient, and if there is neither distant metastasis nor an N2 situation, surgical resection may be indicated. The option for neoadjuvant chemotherapy should always be taken into consideration. Depending on the anatomic tumor location, partial lung resection and resection of the affected aortic wall are performed employing a cardiopulmonary bypass. The resected aortic wall is replaced by a vascular prosthesis. In recent years, this proven procedure has partly been replaced by an alternative one, avoiding extracorporeal circulation. An endoaortic stent is implanted in the affected area followed by partial lung resection and resection of the diseased aortic wall. This new procedure has significantly reduced perioperative mortality and morbidity. With proper patient selection, long-term survival can be improved even in this complex malignoma.
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Irqsusi et al. (2023) conducted a review in T4 Lung Carcinoma with Infiltration of the Thoracic Aorta. Endoaortic stent implantation followed by partial lung and aortic wall resection vs. Partial lung and aortic wall resection employing cardiopulmonary bypass was evaluated on Perioperative mortality and morbidity. Endoaortic stent implantation followed by partial lung and aortic wall resection reduces perioperative mortality and morbidity in T4 lung carcinoma compared to traditional cardiopulmonary bypass.
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