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Technik und Ergebnisse bronchoplastischer Resektionen bei nichtkleinzelligem Bronchialkarzinom

Technique and results of bronchoplastic resections for non-small cell bronchial carcinoma

  • Themenschwerpunkt: Onkologische Thoraxchirurgie
  • Published:
Acta Chirurgica Austriaca Aims and scope Submit manuscript

Zusammenfassung

Grundlagen

Bronchoplastische Resektionen des nichtkleinzelligen Bronchialkarzinoms (NSCLC) beinhalten das Risiko der Anastomoseninsuffizienz und können mit einer hohen Rate an Lokalrezidiven behaftet sein. Unsere Erfahrungen mit dieser Technik werden vorgestellt.

Methodik

In einem 12-Jahres-Zeitraum wurden unter 1478 Operationen wegen NSCLC 102 bronchoplastische Resektionen (6,9%) durchgeführt. Bei 74 Lobektomien, 19 Bilobektomien und 9 Pneumonektomien erfolgten 72 Manschettenresektionen, 28 Bronchuskeil- und 2 Bifurkationsresektionen. 95 Männer und 7 Frauen hatten ein mittleres Alter von 60±6 Jahren.

Ergebnisse

Eine reversible Atelektase trat in 6% auf, in 4% wurde eine Anastomosendehiszenz beobachtet. In 81% erfolgte eine R0-Resektion. Die 30-Tage-Letalität betrug 4%. Die 5-Jahres-Überlebensraten der kurativ operierten Patienten betrugen für die Stadien I, II und III 77%, 55% und 26%.

Schlußfolgerungen

Bronchoplastische Resektionen stellen eine sichere Therapieoption bei der Behandlung des zentralen NSCLC dar.

Summary

Background

Bronchoplastic resections for non-small cell lung cancer (NSCLC) are reported to carry the risk of anastomotic complications and to have a high rate of local recurrence. Our experience with this technique is reported.

Methods

During the past 12 years, among 1478 operations for Non-Small-Cell Lung Cancer (NSCLC), 102 (6,9%) bronchoplastic resections were performed. There were 74 lobectomies, 19 bilobectomies and 9 pneumonectomies done by means of 72 sleeve-, 28 wedge resections and 2 resections of the tracheal bifurcation in 95 men and 7 women with a mean age of 60±6 years.

Results

Reversible atelectasis was observed in 6%, whereas anastomotic dehiscence occurred in 4%. Local complete resection was achieved in 81%. The 30-day-mortality amount to 4%. 5-year survival rate was 77%, 55% and 26% for stages I, II and III.

Conclusions

Bronchoplastic resections represent a safe therapeutic option in the operative management of centrally located NSCLC.

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Authors and Affiliations

  1. Chirurgische Klinik und Poliklinik, Klinikum Großhadern, Marchioninistraße 15, D-81377, München, Deutschland

    C. Müller, C. Schinkel, H. Hoffmann, H. Dienemann & F. W. Schildberg

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  1. C. Müller
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  2. C. Schinkel
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  3. H. Hoffmann
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  4. H. Dienemann
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  5. F. W. Schildberg
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Müller, C., Schinkel, C., Hoffmann, H. et al. Technik und Ergebnisse bronchoplastischer Resektionen bei nichtkleinzelligem Bronchialkarzinom. Acta Chir Austriaca 28, 74–78 (1996). https://doi.org/10.1007/BF02602605

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  • DOI: https://doi.org/10.1007/BF02602605

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