Carinal Resection and Extended Sleeve Lobectomy After Right Upper Sleeve Lobectomy: 1 Step Beyond.

We describe the case of a 54-year-old man with a history of non-small cell lung cancer for which we performed a right upper sleeve lobectomy after chemotherapy. Pathologic examination reported a ypT1 N1 M0 R0 epidermoid carcinoma. Two years later, a local recurrence involving the tracheal carina and the previous anastomosis line was diagnosed. Carinal sleeve resection, including middle sleeve lobectomy extended to segment 6, replacement of the right pulmonary artery, and lower lobe reimplantation in the left main bronchus, was performed, achieving complete resection. Twelve months after the surgery, the patient is recurrence free.