PURPOSE: Extended sleeve lobectomy is a challenging surgery. While induction chemoradiotherapy (ChRT) followed by surgery is one of the therapeutic strategies used for locally advanced non-small cell lung cancer (NSCLC), ChRT can impair the anastomotic healing potential. We herein present our experience with cases who underwent an extended sleeve lobectomy after induction ChRT. METHODS: The medical records of patients who underwent a surgery for NSCLC after ChRT were reviewed. RESULTS: Between December 2007 and January 2013, nine patients underwent an extended sleeve lobectomy; the left lingular division and lower lobe in four patients, the right upper lobe and trachea in one patient, the carina and trachea in one patient, the right middle and lower lobes in one patient, the right upper and middle lobes and carina in one patient and the right upper lobe and superior segment of the lower lobe in one patient. While no postoperative 90-day deaths occurred, one case developed a bronchopleural fistula on postoperative day (POD) 25 and one case developed a bronchovascular fistula on POD 163. No cases of local recurrence developed. CONCLUSIONS: Our experience suggests that an extended sleeve lobectomy after induction ChRT is feasible, but careful patient selection and perioperative management are mandatory.
PURPOSE: Extended sleeve lobectomy is a challenging surgery. While induction chemoradiotherapy (ChRT) followed by surgery is one of the therapeutic strategies used for locally advanced non-small cell lung cancer (NSCLC), ChRT can impair the anastomotic healing potential. We herein present our experience with cases who underwent an extended sleeve lobectomy after induction ChRT. METHODS: The medical records of patients who underwent a surgery for NSCLC after ChRT were reviewed. RESULTS: Between December 2007 and January 2013, nine patients underwent an extended sleeve lobectomy; the left lingular division and lower lobe in four patients, the right upper lobe and trachea in one patient, the carina and trachea in one patient, the right middle and lower lobes in one patient, the right upper and middle lobes and carina in one patient and the right upper lobe and superior segment of the lower lobe in one patient. While no postoperative 90-day deaths occurred, one case developed a bronchopleural fistula on postoperative day (POD) 25 and one case developed a bronchovascular fistula on POD 163. No cases of local recurrence developed. CONCLUSIONS: Our experience suggests that an extended sleeve lobectomy after induction ChRT is feasible, but careful patient selection and perioperative management are mandatory.
Authors: Jean Deslauriers; Jocelyn Grégoire; Louis F Jacques; Michel Piraux; Liu Guojin; Yves Lacasse Journal: Ann Thorac Surg Date: 2004-04 Impact factor: 4.330
Authors: Federico Venuta; Anna Maria Ciccone; Marco Anile; Mohsen Ibrahim; Tiziano De Giacomo; Giorgio F Coloni; Erino A Rendina Journal: J Thorac Cardiovasc Surg Date: 2009-09-09 Impact factor: 5.209
Authors: H Katayama; H Ueoka; K Kiura; M Tabata; T Kozuki; M Tanimoto; T Fujiwara; N Tanaka; H Date; M Aoe; N Shimizu; M Takemoto; Y Hiraki Journal: Br J Cancer Date: 2004-03-08 Impact factor: 7.640