Surgical outcome of pulmonary artery reconstruction using the expanded polytetrafluoroethylene patch in patients with lung cancer

  • Mitsuru YoshinoEmail author
  • Yukio Saitoh
  • Masako Chiyo
  • Hidehisa Hoshino
  • Yasuo Sekine
  • Hironobu Wada
  • Hidemi Suzuki
  • Ichiro Yoshino
Original Article



Pulmonary artery reconstruction is sometimes utilized as an alternative to pneumonectomy in lung cancer surgery. We herein report our experience of pulmonary artery reconstruction using an expanded polytetrafluoroethylene (ePTFE) patch based on the surgical results and long-term outcome.


Clinical records of lung cancer patients who underwent patch plasty were reviewed retrospectively.


Between 2003 and 2017, pulmonary artery patch plasty were performed in 21 patients [18 males, 3 females; mean age 65 (range 47–79) years]. Induction chemoradiotherapy was performed in three patients. Bronchoplasty was performed in five patients. The pathologic stages were stage I in 3 patients, stage II in 6 and stage III in 12. Pneumonectomy, lobectomy and segmentectomy were performed in 2, 18 and 1 patient, respectively. The left upper lobe was the most frequent origin of lung cancer (15 patients). There was no reconstruction-related morbidity or mortality. The overall survival rate at 5 years was 64.1% with a mean follow-up of 39.5 months, and the survival rates for N0–1 and N2–3 were 80.8% and 28.6%, respectively.


Patch angioplasty using the ePTFE sheet is a reliable procedure in radical surgery for lung cancer.


Lung cancer Surgery Pulmonary artery reconstruction ePTFE patch 


Compliance with ethical standards

Conflict of interest

Yoshino M. and the other co-authors have no conflicts of interest.


  1. 1.
    Amano J, Kuwano H, Yokomise H. Thoracic and cardiovascular surgery in Japan during 2011: annual report by The Japanese Association for Thoracic Surgery. Gen Thorac Cardiovasc Surg. 2013;61(10):578–607.CrossRefGoogle Scholar
  2. 2.
    Cerfolio RJ, Bryant AS. Surgical techniques and results for partial or circumferential sleeve resection of the pulmonary artery for patients with non-small cell lung cancer. Ann Thorac Surg. 2007;83(6):1971–6.CrossRefGoogle Scholar
  3. 3.
    Rendina EA, Venuta F, De Giacomo T, Ciccone AM, Moretti M, Ruvolo G, et al. Sleeve resection and prosthetic reconstruction of the pulmonary artery for lung cancer. Ann Thorac Surg. 1999;68(3):995–1001.CrossRefGoogle Scholar
  4. 4.
    Venuta F, Ciccone AM, Anile M, Ibrahim M, De Giacomo T, Coloni GF, et al. Reconstruction of the pulmonary artery for lung cancer: long-term results. J Thorac Cardiovasc Surg. 2009;138(5):1185–91.CrossRefGoogle Scholar
  5. 5.
    Ma Q, Liu D, Guo Y, Shi B, Tian Y, Song Z, et al. Surgical techniques and results of the pulmonary artery reconstruction for patients with central non-small cell lung cancer. J Cardiothorac Surg. 2013;1(8):219. Scholar
  6. 6.
    Galetta D, Borri A, Gasparri R, Petrella F, Spaggiari L. Surgical techniques and long-term results of pulmonary artery reconstruction in patients with lung cancer. Ann Thorac Surg. 2015;100(4):1196–202.CrossRefGoogle Scholar
  7. 7.
    D’Andrilli A, Maurizi G, Ciccone AM, Andreetti C, Ibrahim M, Menna C, et al. Long-segment pulmonary artery resection to avoid pneumonectomy: long-term results after prosthetic replacement. Eur J Cardiothorac Surg. 2018;53(2):331–5.CrossRefGoogle Scholar
  8. 8.
    Venuta F, Ciccone AM. Reconstruction of the pulmonary artery. Semin Thorac Cardiovasc Surg. 2006;18(2):104–8.CrossRefGoogle Scholar
  9. 9.
    Solli P, Spaggiari L, Grasso F, Pastorino U. Double prosthetic replacement of pulmonary artery and superior vena cava and sleeve lobectomy for lung cancer. Eur J Cardiothorac Surg. 2001;20(5):1045–8.CrossRefGoogle Scholar
  10. 10.
    Read RC, Ziomek S, Ranval TJ, Eidt JF, Gocio JC, Schaefer RF. Pulmonary artery sleeve resection for abutting left upper lobe lesions. Ann Thorac Surg. 1993;55(4):850–4.CrossRefGoogle Scholar
  11. 11.
    Alifano M, Cusumano G, Strano S, Magdeleinat P, Bobbio A, Giraud F, et al. Lobectomy with pulmonary artery resection: morbidity, mortality, and long-term survival. J Thorac Cardiovasc Surg. 2009;137(6):1400–5.CrossRefGoogle Scholar
  12. 12.
    Ricci C, Rendina EA, Venuta F, Ciriaco PP, De Giacomo T, Fadda GF. Reconstruction of the pulmonary artery in patients with lung cancer. Ann Thorac Surg. 1994;57(3):627–32.CrossRefGoogle Scholar
  13. 13.
    Puma F, Capozzi R, Daddi N, Ragusa M, Cagini L, Quintili A, et al. Experience with the autologous pulmonary vein for pulmonary arterioplasty. Eur J Cardiothorac Surg. 2011;40(3):e107–11.Google Scholar
  14. 14.
    Cerezo F, Cano JR, Espinosa D, Salvatierra A. New technique for pulmonary artery reconstruction. Eur J Cardiothorac Surg. 2009;36(2):422–3.CrossRefGoogle Scholar
  15. 15.
    Berthet JP, Boada M, Paradela M, Molins L, Matecki S, Marty-Ané CH, et al. Pulmonary sleeve resection in locally advanced lung cancer using cryopreserved allograft for pulmonary artery replacement. J Thorac Cardiovasc Surg. 2013;146(5):1191–7.CrossRefGoogle Scholar
  16. 16.
    Yoshida K, Toishi M, Agatsuma H, Kumeda H, Eguchi T, Terada Y, et al. Pulmonary artery reconstruction with a prosthetic conduit in lung cancer. Ann Thorac Cardiovasc Surg. 2014;20(Suppl):505–8.CrossRefGoogle Scholar
  17. 17.
    Lausberg HF, Graeter TP, Tscholl D, Wendler O, Schäfers HJ. Bronchovascular versus bronchial sleeve resection for central lung tumors. Ann Thorac Surg. 2005;79(4):1147–52.CrossRefGoogle Scholar
  18. 18.
    Shrager JB, Lambright ES, McGrath CM, Wahl PM, Deeb ME, Friedberg JS, et al. Lobectomy with tangential pulmonary artery resection without regard to pulmonary function. Ann Thorac Surg. 2000;70(1):234–9.CrossRefGoogle Scholar
  19. 19.
    Sawabata N, Miyaoka E, Asamura H, Nakanishi Y, Eguchi K, Mori M, Japanese Joint Committee for Lung Cancer Registration, et al. Japanese lung cancer registry study of 11,663 surgical cases in 2004: demographic and prognosis changes over decade. J Thorac Oncol. 2011;6(7):1229–35.CrossRefGoogle Scholar
  20. 20.
    Zhang YK, Chai ZD, Tan LL, Wang ZY, Chen ZJ, Le HB, et al. Association of lymph node involvement with the prognosis of pathological T1 invasive non-small cell lung cancer. World J Surg Oncol. 2017;15(1):64. Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Mitsuru Yoshino
    • 1
    Email author
  • Yukio Saitoh
    • 1
  • Masako Chiyo
    • 1
  • Hidehisa Hoshino
    • 2
  • Yasuo Sekine
    • 2
  • Hironobu Wada
    • 3
  • Hidemi Suzuki
    • 3
  • Ichiro Yoshino
    • 3
  1. 1.Department of Thoracic SurgeryNational Hospital Organization Chiba Medical CenterChibaJapan
  2. 2.Department of Thoracic SurgeryTokyo Women’s Medical University, Yachiyo Medical CenterYachiyoJapan
  3. 3.Department of General Thoracic SurgeryChiba University Graduate School of MedicineChibaJapan

Personalised recommendations