Reported in this paper is experience obtained since 1978 from surgical removal of the tracheal bifurcation in combination with pneumonectomy in 38 cases. Squamous cell carcinoma centrally growing from the upper lobe was recorded from 24 patients to whom 36 interventions had been applied for bronchial carcinoma. 50 per cent of all operations in conjunction with pneumonectomy were performed on patients in the pT3NOMO stage. The cumulated 3-year survival rate amounted to 37 per cent. Mortality in hospital accounted for 18.4 per cent and was thus clearly higher than what had been recordable from standard techniques in carcinoma surgery. Causes of postoperative deaths included insufficient sutures in three cases, pulmonary embolism in 2, and pneumonia in the contralateral residual lung in another 2. Standardised surgical and anaesthesiological techniques were used. Modifications of resections are discussed.
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