Left sleeve pneumonectomy performed through a clamshell incision with extracorporeal membrane oxygenation for bronchogenic carcinoma: report of two cases.

We report herein the cases of two patients with bronchial gland carcinomas in the left main bronchus who were successfully treated by left sleeve pneumonectomy performed through a clamshell incision. Adequate oxygenation during pathological examination of tumor invasion at the bronchial stumps and the tracheobronchial anastomoses was achieved by extracorporeal membrane oxygenation (ECMO) in both patients. Tracheobronchial anastomosis was relatively easy to perform in the excellent operative field achieved by this method. The postoperative courses of both patients were uneventful, although they developed temporary pulmonary edema that was effectively controlled by mechanical ventilation and appropriate diuresis. The procedure presented in this paper is considered to be a safe and effective method of performing left sleeve pneumonectomy.