Introduction: Despite the advent of targeted therapies of bronchopulmonary cancer, enlarged resection still remains the therapeutic alternative in patients with locally advanced disease. our aim is to report our experience with enlarged pneumonectomies and to evaluate its postoperative morbidity and mortality.

Methods : Retrospectively,36 patients with lung cancer had an intrapericardial pneumonectomy or extended to the carina managed between 2010 and 2020 at the thoracic surgery department of Abderrahmen Mami Ariana hospital.

Results :there were 31men and 5 women,with mean age of 58years. In medical history:chronic smoking(n=31),COPD(n=5), pulmonary tuberculosis (n=1). The clinical symptoms were: haemoptysis (n=17),dyspnoea (n=4),chronic bronchorrhoea(n=3) and chest pain(n=6).Imaging tools showed a tumor process, central (n=32), peripheral with scissural crossing (n=1),lymph node mass(n=1) and a bilobar tissue process(n=2). Bronchial fibroscopy confirmed the stenosing endobronchial tumor(n=13).The approach was a posterolateral thoracotomy. The procedures performed were: intrapericardial pneumonectomy in 19 cases, extended to the carina(n=17) associated with a radical mediastinal lymphadenectomy. The histological diagnosis was: adenocarcinoma(n=11), squamous cell carcinoma(n=21), poorly differentiated carcinoma (n=3).The early post-operative course was complicated in 21 cases haemothorax(n=5),pyothorax(n=1),contralateral pneumopathy(n=7), cardiac rhythm disorder(n=6) and death(n=2).During follow-up, tumor recurrence was noted(n=21).

Conclusion: Extended pneumonectomy is a surgical technique that aim to carcinological resection at the expense of a pre-, per- and postoperative tactic adapted to each case.