Source: Annual Congress 2002 - Chest trauma, airways and miscellaneous
Disease area: Thoracic oncology

Abstract

Saving pulmonary surgery allows to perform a restricted resection in patients with worse respiratory functional indexes and in which a bronchial spurs infiltration would require a wider resection.
Among 3000 operations for lung cancer we have performed 196 broncho-angioplastic procedures (99 bronchial wedge resections, 97 bronchial sleeve resections, associated in 17 cases to a sleeve resection of the pulmonary artery and in 9 to a tangential artery resection with a plastic enlargement performed using a bovine pericardium patch).
After sleeve procedures 3 patients (3%) died: 1 for massive aemophtisis in 16th day, 2 patients died for pulmonary embolisations (despite of pharmacological therapy).
Morbidity was: 1 postoperatory complicacy due to a partial dehiscence of the anasthomosis required a pneumonectomy, 1 late stenosis of the anastomosis required a laser treatment.
We reviewed the survival rate in comparison with the pathological stage in a group of 75 patients, 72 with NSCLC: best results are obtained in stage I, with 53,1% of patients alive at 5 years and 50% at over 5 years. Worse results in stages II and III, but similar to that reported for same cases treated with pneumonectomies.
In our series 2 of the 23 long surviving patients were successfully treated for local recurrence in the operated lung in one case with local laser therapy and with residual pneumonectomy in the other, and 1 patient presented a second cancer in the controlateral lung and was successfully operated.
In conclusion quality of life was good, long-term results are related to nodal stage, similar to that seen after pneumonectomy for the same stage.
These techniques are safe and effective therapy but with lower postoperative risks in comparison with pneumonectomy.

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Citations should be made in the following way:
P. Bovolato, D. Benetti, M. Benvenuti, G. Botticini, M. Mondini, G. L. Pariscenti, G. Mombelloni (Brescia, Italy). Bronchial sleeve resections: a safe and effective therapy. Eur Respir J 2002; 20: Suppl. 38, 983

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