Preliminary Results of Extracorporeal Membrane Oxygenation Assisted Tracheal Sleeve Pneumonectomy for Cancer

ObjectiveTracheal sleeve pneumonectomy is a challenge in lung cancer manage-ment and in achieving long-term oncological results. In November 2018, we started aprospectivestudyontheroleofextracorporealmembraneoxygenation(ECMO)intracheal sleeve pneumonectomy. We aim to present our preliminary results.MethodsFrom November 2018 to November 2019, six patients (three men and threewomen; median age: 61 years) were eligible for tracheal sleeve pneumonectomy forlung cancer employing the veno-venous ECMO during tracheobronchial anastomosis.ResultsOnly in one patient, an intrapericardial pneumonectomy without ECMOsupport was performed, but cannulas weremaintained during surgery. The medianlength of surgery was 201 minutes (range: 162–292 minutes), and the averageduration of the apneic phase was 38 minutes (range: 31–45 minutes). No complica-tions correlated to the positioning of the cannulas were recorded. There was only onemajor postoperative complication (hemothorax). At the time of follow-up, all patientswere alive; one patient alive with bone metastasis was being treated with radiotherapy.ConclusionECMO-assisted oncological surgery was rarely described, and its advan-tages include hemodynamic stability with low bleeding complications and a cleanoperatingfield. As suggested by our preliminary data, ECMO-assisted could be a usefulalternative strategy in select lung cancer patients.