| Summary: | <p>Abstract</p> <p>Background</p> <p>To report our experience for the treatment of lung tumors of the right main bronchus (RMB) invading the carina.</p> <p>Methods</p> <p>From February 2000 till January 2007 we have identified 8 cases (1.09%) requiring carinal surgery.</p> <p>Plan of action: Close cooperation with anaesthetics, long flexible ET tube, Right posterolateral thoracotomy, no irrevocable steps until resection guaranteed, mobilization of trachea and main bronchus, division of the trachea & Left main bronchus. Intubate across surgical field. Tailoring for airway size discrepancies, appropriately. Construction of the tracheobronchial anastomosis around the ventilatory tube. Skillfull reintubation, over a long boogie.</p> <p>Results</p> <p>Mortality: 12.5% due to ARDS (one patient)</p> <p>Morbidity: anastomotic stenosis requiring stent (one patient). Follow-up 52 ± 11 months.</p> <p>Recurrences: 2 patients (both with pathological N2 disease on histology).</p> <p>Conclusions</p> <p>Success of carinal surgery depends on careful patient selection, team approach and attention to detail. Patients with N2 disease carry the worst prognosis.</p>
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