Serkan Yazgan1, Soner Gürsoy1, Ahmet Üçvet1, Tarık Yağcı1, Mehmet Ünal1, Özgür Samancılar1, Ahmet Emin Erbaycu2. 1. Department of Thoracic Surgery, University of Health Sciences, Dr. Suat Seren Chest Diseases and Surgery Training and Research Hospital, İzmir, Turkey. 2. Department of Thoracic Diseases, University of Health Sciences, Dr. Suat Seren Chest Diseases and Surgery Training and Research Hospital, İzmir, Turkey.
Abstract
BACKGROUND: This study aims to investigate the operation-related complications, recurrence frequency, morbidity, mortality and survival rates as well as variables effective on survival of patients undergoing bronchial sleeve lobectomy due to primary non-small cell lung cancer. METHODS: A total of 85 patients ( 80 males, 5 females; mean age 59.9±8.4 years; range, 35 to 77 years) of bronchial sleeve lobectomy operated with the same surgical technique by the same team in our clinic between May 2007 and November 2015 were analyzed retrospectively. Survival and 30- and 90-day mortality rates were analyzed. Variables effective on survival rate were evaluated statistically. Complications related to bronchial anastomosis and the frequency of local recurrence in postoperative period were investigated. RESULTS: Twenty-five patients (29.4%) received neoadjuvant therapy and two of these patients (8%) developed complication in the anastomosis line. Local recurrence rate in the postoperative follow-up was 16.5%. Mean duration of follow-up was 35±29.9 months, median survival was 65.2 months, and five-year survival rate was 50.9%. Thirty- and 90-day mortality rates were 1.2% and 2.4%, respectively. In univariate analysis, patients with larger tumors, N2 disease, or those who underwent extended surgery had statistically significantly worse survival rates (p=0.001, p=0.002, and p=0.0001, respectively). In the Cox regression analysis, variables effective on survival were presence of extended surgery and node status (p=0.03 and p=0.012, respectively). CONCLUSION: Sleeve lobectomy can be achieved with acceptable anastomotic complications, good survival and low mortality rates using continuous suture technique. When performed due to oncological reasons, its long-term results are not different from pneumonectomy.
BACKGROUND: This study aims to investigate the operation-related complications, recurrence frequency, morbidity, mortality and survival rates as well as variables effective on survival of patients undergoing bronchial sleeve lobectomy due to primary non-small cell lung cancer. METHODS: A total of 85 patients ( 80 males, 5 females; mean age 59.9±8.4 years; range, 35 to 77 years) of bronchial sleeve lobectomy operated with the same surgical technique by the same team in our clinic between May 2007 and November 2015 were analyzed retrospectively. Survival and 30- and 90-day mortality rates were analyzed. Variables effective on survival rate were evaluated statistically. Complications related to bronchial anastomosis and the frequency of local recurrence in postoperative period were investigated. RESULTS: Twenty-five patients (29.4%) received neoadjuvant therapy and two of these patients (8%) developed complication in the anastomosis line. Local recurrence rate in the postoperative follow-up was 16.5%. Mean duration of follow-up was 35±29.9 months, median survival was 65.2 months, and five-year survival rate was 50.9%. Thirty- and 90-day mortality rates were 1.2% and 2.4%, respectively. In univariate analysis, patients with larger tumors, N2 disease, or those who underwent extended surgery had statistically significantly worse survival rates (p=0.001, p=0.002, and p=0.0001, respectively). In the Cox regression analysis, variables effective on survival were presence of extended surgery and node status (p=0.03 and p=0.012, respectively). CONCLUSION: Sleeve lobectomy can be achieved with acceptable anastomotic complications, good survival and low mortality rates using continuous suture technique. When performed due to oncological reasons, its long-term results are not different from pneumonectomy.