Four cases of primary lung carcinoma (two squamous cell carcinomas and two adenocarcinomas) were performed right middle lobectomy combination with the reconstruction of upper pulmonary vein to remain the upper lobe. Lung carcinomas were in the right lobe and infiltrated to lower margin of upper pulmonary vein in all cases. After resection of the right middle lobe and an affected portion of upper pulmonary vein, the defect of the upper pulmonary vein was replaced with auto-pericardial graft in three cases, and the other one was closed by continuous suture of 5-0 plorene. Pathological classification of these four cases was stage IB in one patient, stage IIB in two and stage IV in one. All patients died from 6 to 53 months after operation (average: 31 months). Metastasis to distant organs was confirmed in all cases, so the prognosis of them was generally poor. Reconstruction of pulmonary vein may be feasible to avoid over resection of other lobes, because pulmonary function can be preserve as well as in the bronchoplasty.