WORLD JOURNAL OF ADVANCE
HEALTHCARE RESEARCH

M. Lakranbi*, F. Z. Ammor, S Rabiou, L. Bellirej, H. Harmouchi, Y. Ouadnouni and M. Smahi

ABSTRACT

Introduction: Indications for carina surgery are rare, limited to tumors of the lower trachea or the main bronchi, offering carcinologic resection R0 and a better prognosis at the expense of a operative tactic specially adapted to each case It’s about a Retrospective study about 5 cases, benefiting from a resection of the hull with or without pulmonary resection, associated with a carinoplasty under different techniques (8 years), 3 men and 2 women, whose average age was 41 years. The radiological assessment objectified a central tumor process (Hilar 2cases, subcarinary 2cases, endobronchial 1case), associated with mediastinal lymphadenopathy in 4cases and an aspect of right lung destroyed in 3cases. By a right postero lateral thoracotomy (4cases) and a sternotomy (1cases), the gestures carried out were: right intrapericardial pneumonectomy enlarged to the carina with reconstruction by a KERGIN type (1case), inverted KERGIN (1case), a V-plasty 1 case); tumor excision enlarged to the carina with angular section and V-shaped plasty (1case); resection of the carina with tracheobronchial anastomosis in double rifle barrel (1 case), associated with radical mediastinal lymph node dissection. The histological diagnosis was : moderately differentiated ADK, poorly differentiated carcinoma, mucoepidermoide carcinoma, typical carcinoid tumor (2cases). During an average follow-up of 4.75 years, an immediate postoperative death and a recurrent cervical lymph node were noted Conclusion: Carinoplasty is technically difficult, requiring perfect collaboration between pulmonologists, surgeons and anesthesiologists, to deal with a problem linked to: approaches, mobilization techniques, type of resection-anastomosis and postoperative.

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