Does Induction Therapy Increase Anastomotic Complications in Bronchial Sleeve Resections?

  • Giovanni M. ComacchioEmail author
  • Marco Schiavon
  • Danila Azzolina
  • Marco Mammana
  • Giuseppe Marulli
  • Andrea Zuin
  • Enrico Verderi
  • Nicola Monaci
  • Laura Bonanno
  • Giulia Pasello
  • Federico Rea
Original Scientific Report



Sleeve lobectomy represents a safe and effective treatment for central NSCLC to avoid the risks of pneumonectomy. Induction therapy (IT) may be indicated in advanced stages; however, the effect of IT on bronchial anastomoses remains uncertain. The purpose of the study was to evaluate the impact of IT on the complications of the anastomoses.


Between 2000 and 2012, 159 consecutive patients were submitted to sleeve lobectomy for NSCLC at our Institution. We retrospectively compared the results of patients who underwent IT before operation with those who received upfront surgery.


In the study period, 49 (30.8%) patients received IT (37 chemotherapy, 1 radiotherapy and 11 chemo-radiotherapy) and 110 (69.2%) patients were directly submitted to surgery (S). The two groups were comparable for sex, age, comorbidities, ASA score, pulmonary function, side, type of procedure and histology. Pathological stage was statistically higher for IT group (p = 0.001). No differences between IT and S groups were observed in terms of post-operative mortality (2% vs 0%, p = NS), morbidity (45% vs 38%, p = NS), including early (6% vs 9%, p = NS) and long-term (16% vs 14%, p = NS) bronchial complication rates. Patients undergoing induction mediastinal radiotherapy, however, are at higher risk of bronchial complications.


In our experience, the use of induction chemotherapy did not significantly increase mortality and morbidity rates, in particular, neither for early nor for late anastomotic complications. We, therefore, conclude that sleeve lobectomy after induction chemotherapy is safe and reliable procedure for the treatment of locally advanced NSCLC.


Compliance with ethical standards

Conflict of interest

The authors declare that there is no conflict of interest.


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Copyright information

© Société Internationale de Chirurgie 2019

Authors and Affiliations

  • Giovanni M. Comacchio
    • 1
    Email author
  • Marco Schiavon
    • 1
  • Danila Azzolina
    • 2
  • Marco Mammana
    • 1
  • Giuseppe Marulli
    • 3
  • Andrea Zuin
    • 1
  • Enrico Verderi
    • 1
  • Nicola Monaci
    • 1
  • Laura Bonanno
    • 4
  • Giulia Pasello
    • 4
  • Federico Rea
    • 1
  1. 1.Division of Thoracic Surgery, Department of Cardio-Thoracic and Vascular SciencesUniversity of PadovaPaduaItaly
  2. 2.Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular SciencesUniversity of PadovaPaduaItaly
  3. 3.Thoracic Surgery Unit, Department of Emergency and Organ TransplantationUniversity HospitalBariItaly
  4. 4.Second Medical Oncology UnitIstituto Oncologico Veneto, IRCCSPaduaItaly

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