Right sleeve pneumonectomy for local recurrent lung cancer following right sleeve upper lobectomy with bronchoplasty: a case report

BACKGROUND: Salvage surgery has been frequently performed, increasing the opportunity to actively perform surgery for recurrence after a function-preserving operation. However, re-operation after airway reconstruction surgery on the proximal side and the effect of prior treatment, such as radiotherapy and/or chemotherapy, make the operation more difficult. In addition, cases of sleeve pneumonectomy after sleeve lobectomy with bronchoplasty are uncommon. CASE PRESENTATION: A 71-year-old lung cancer patient underwent right upper sleeve lobectomy with bronchoplasty combined with perioperative chemotherapy in 2007. A new undiagnosed right hilar mass that appeared 9 years post-operation showed a temporary response to radiotherapy but progressed thereafter. Sleeve pneumonectomy was completed 14 months after radiotherapy by the following procedures: dividing the right pulmonary artery at the proximal site under median sternotomy and then reconstructing the bronchus by telescoping the left main bronchus into the distal trachea after pneumonectomy under posterolateral thoracotomy. CONCLUSIONS: Sleeve pneumonectomy for recurrent lung cancer could be safely performed under good vision using a two-stage approach as salvage surgery, even in high-risk patients who received various treatments and proximal airway reconstruction.