Combined approach for a left pneumonectomy and carinal reconstruction.

Tumor involving the carina is a real challenge to thoracic surgeons due to the complexity of airway reconstruction and management. Carinal resection is a safe procedure in highly selected patients with acceptable morbidity and mortality and good long-term survival. A 32-year-old lady with adenoid cystic carcinoma arising from the left main bronchus underwent carinal pneumonectomy using a combined thoracotomy and midline sternotomy approach without the use of cardiopulmonary bypass.