Video-assisted thoracoscopic segmentectomy of right lung cancer with extracorporeal lung assist after left completion pneumonectomy

Abstract

Background. Few reports have described the outcomes of three-time lung resection for metachronous multiple lung cancers or anatomical lung resection after pneumonectomy. Case. A 66-year-old man with a nodule in the left lung was treated with left upper lobectomy at 50 years of age and left lower lobectomy at 61 years of age. In both cases, the pathological diagnosis was minimally invasive adenocarcinoma, stage IA1. He visited our hospital for the further examination of an abnormal chest shadow noted at a medical checkup. The preoperative residual pulmonary function was as follows: VC 2.321, %VC 70.7%, FEV1.0 1.59 1, and FEV1.0% 70.1%. Although there was no definitive diagnosis, computed tomography revealed findings suggestive of primary lung cancer. He underwent superior segmentectomy (segment 6) of the right lower lobe with extracorporeal lung assist (ECLA). The postoperative course was uneventful. He was discharged home 14 days after the surgery. The pathological diagnosis was still adenocarcinoma in situ. Conclusion. Using ECLA, we were able to perform thoracoscopic segmentectomy for a metachronous multiple lung cancers (metachronous triple cancers) safely after pneumonectomy.