Extended sleeve lobectomy for centrally located non-small-cell lung cancer: A 20-year single-centre experience

Tae Hee Hong, Jong Ho Cho, Sumin Shin, Hong Kwan Kim, Yong Soo Choi, Jae Il Zo, Young Mog Shim, Jhingook Kim

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

OBJECTIVES: Extended sleeve lobectomy (ESL), an atypical bronchoplasty with resection of more than 1 lobe, might be technically demanding but has certain theoretical advantages, including the avoidance of pneumonectomy. However, clinical outcomes after ESL are not well known. METHODS: Between March 1995 and December 2015, 540 patients with centrally located non-small-cell lung cancer underwent sleeve resection. Among them, 63 patients underwent an ESL procedure. We retrospectively analysed those patients in terms of hospital mortality, postoperative complications and local recurrence and compared clinical outcomes with patients who underwent simple sleeve lobectomy in the same period. RESULTS: The 63 patients were classified into 4 groups: anastomosis between the right main and lower bronchi (n = 14), anastomosis between the right main and upper bronchi (n = 37), anastomosis between the left main and basal segmental bronchi (n = 4) and anastomosis between the left main and upper divisional bronchi (n = 8). No operative deaths occurred within 30 days, but there were 2 in-hospital deaths from postoperative acute lung injury. Ten (16%) patients had anastomosis-related complications including 3 strictures, 5 bronchopleural fistulas and 2 pulmonary vein thromboses. There were no significant differences in in-hospital mortality (3% vs 3%, P = 0.67), anastomosis-related complications (16% vs 9%, P = 0.07) and loco-regional recurrence rate (8% vs 10%, P = 0.63) between ESL and simple sleeve lobectomy. CONCLUSIONS: According to our findings, ESL is a safe and feasible procedure that does not compromise oncological principles. It can be considered an appropriate alternative to pneumonectomy and should be considered in patients with centrally located tumours.

Original languageEnglish
Pages (from-to)142-148
Number of pages7
JournalEuropean Journal of Cardio-thoracic Surgery
Volume54
Issue number1
DOIs
StatePublished - 1 Jul 2018

Keywords

  • Extended sleeve lobectomy
  • Lung cancer
  • Lung preservation
  • Pneumonectomy
  • Sleeve lobectomy

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