Surgical Outcome After Extended Sleeve Lobectomy in Centrally Located Non-small Cell Lung Cancer.

Abstract

BACKGROUND:

We primarily aimed to evaluate the operative techniques, clinicopathologic characteristics, and surgical outcomes after extended sleeve lobectomy (ESL). Additionally, we evaluated the feasibility of ESL for centrally located non-small cell lung cancer (NSCLC) compared with pneumonectomy (PN).

METHODS:

A retrospective review identified 119 patients who underwent pulmonary resections for centrally located NSCLC; of whom, 43 underwent ESLs and 76 underwent PNs. Perioperative morbidity and oncologic outcomes of ESL were analyzed. Postoperative morbidity was evaluated according to the Common Terminology Criteria for Adverse Events version 5.0. Overall survival was evaluated using a Cox proportional hazard model.

RESULTS:

According to the classifications of ESL, 10 patients comprised type A, 8 (19%) type B, 16 (37%) type C, and 9 (21%) type D. Pulmonary artery reconstructions were performed in 5 of type A, 8 of type B, 1 of type C, and 1 of type D, and pulmonary vein reconstructions occurred in 3 of type A and 2 of type C. After ESL, 30-day hospital mortality occurred in 1 patient (2.3%), and grade ≥3 morbidities occurred in 13 patients (30%). In particular, bronchial anastomosis/stump fistula was seen in 4 patients (9.3%) after ESL, and blood perfusion disorders due to the presence of thrombi were seen in 4 (9.3%). The 3-year overall survival was significantly better after ESL compared with that after PN (62.8% vs 45.2%, P = .047).

CONCLUSIONS:

ESLs to preserve lung parenchyma will likely become a promising operative strategy in appropriately selected patients with centrally located NSCLC.

• Authors: Aritoshi Hattori, Takeshi Matsunaga, Mariko Fukui, Kazuya Takamochi, Shiaki Oh, Kenji Suzuki
• Journal: The Annals of thoracic surgery (Ann Thorac Surg) Vol. 114 Issue 5 Pg. 1853-1862 (11 2022) ISSN: 1552-6259 [Electronic] Netherlands
• PMID: 35398037 (Publication Type: Journal Article)
• Copyright: Copyright © 2022 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Topics

• Humans
• Carcinoma, Non-Small-Cell Lung
• Pneumonectomy (methods)
• Lung Neoplasms (pathology)
• Anastomosis, Surgical (methods)
• Retrospective Studies
• Treatment Outcome