In this video, the author presents a Barclay's type of carinal resection. The patient was a 54-year-old woman who had coughing, wheezing, and shortness of breath.
Chest x-ray and computed tomography (CT) scan showed air trapping in the left lung and a carinal mass. Bronchoscopy revealed a broad-based mass at the left tracheobronchial angle. The result of bronchoscopic biopsy was adenoid cystic carcinoma. Right thoracotomy was performed as a standard technique. The carina was dissected, the left main bronchus was transected and intubated, and then the carinal resection was completed. Frozen sectioning showed the surgical margins to be disease-free. The trachea and right main bronchus were anastomosed with 3/0 PDS® running suture. The right lung was ventilated with an endotracheal tube. The proximal bronchus intermedius was clamped, and a hole was created at the distal part of the bronchus intermedius. Then, an end-to-side anastomosis was performed between the left main and intermediate bronchus using a running suture with 3/0 PDS®. The final view of the airway before the chest was closed is shown in the video. The anastomoses were found to be intact during a bronchoscopy performed one week after the operation. The video shows the coronal section of the CT scan three months after the operation.
