Abstract
Purpose
Although bronchoplasty for the treatment of lung cancer is widely accepted as a reliable, safe procedure for the preservation of lung function, there have been only a few reports on pulmonary artery (PA) resection and reconstruction.
Methods
Retrospectively, we reviewed our medical records of pulmonary angioplastic procedures and assessed the results.
Results
A total of 25 patients (5 women, 20 men) with a mean age of 68 years (range 44–85 years) underwent a pulmonary angioplastic procedure for lung cancer surgery. Altogether, 13 patients had adenocarcinoma, and 11 had squamous cell carcinoma. The cancers were located in the left lung in 15 cases and in the right lung in 10 cases. The PA reconstructions comprised 4 circumferential resections and anastomoses, 18 wedge resections and end-to-end anastomoses, 2 tangential resections with direct suturing, and 1 wide wedge resection and autologous pericardial patch repair. Six patients underwent concomitant bronchoplasty with pulmonary artery reconstruction. Prior to surgical treatment, seven patients had received neoadjuvant therapy. Although early postoperative complications occurred in eight patients (32%), no operative or in-hospital deaths occurred. All the patients in this series were discharged from hospital and went home. The overall 5-year survival rate was 45%, with a mean 27 months of follow-up.
Conclusion
Most operative complications after PA reconstruction were controllable despite the high morbidity rate. Pulmonary angioplastic procedures for the surgical treatment of lung cancer are both useful and feasible with good intermediate-term results.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Deslauriers J, Gregorie J, Jacques LF, Paraux M, Guojin L, Lacasse. Sleeve lobectomy versus pneumonectomy for lung cancer: a comparative analysis of survival and sites or recurrences. Ann Thorac Surg 2004;77:1152–1156.
Bagan P, Berna P, Pereira JCDN, Barthes FLP, Foucault C, Dujon A, et al. Sleeve lobectomy versus pneumonectomy: tumor characteristics and comparative analysis of feasibility and results. Ann Thorac Surg 2005;80;2046–2050.
Rendina EA, Giacomo TD, Venuta F, Ciccone AM, Coloni GF. Lung conservation techniques: Bronchial sleeve resection and reconstruction of the pulmonary artery. Semin Surg Oncol 2000;18:165–172.
Cerfolio RJ, Bryant A. Surgical techniques and results for partial or circumferential sleeve resection of pulmonary artery for patients with non-small cell lung cancer. Ann Thorac Surg 2007;83:1971–1977.
Ma Z, Dong A, Fan J, Cheng H. Does sleeve lobectomy concomitant with or without pulmonary artery reconstruction (double sleeve) have favorable results for non-small cell lung cancer compared with pneumonectomy? A meta-analysis. Eur J Cardiothorac Surg 2007;32:20–28.
Yamashita M, Shimizu N, Maruyama S, Ichiba S, Okabe K, Sanao Y, et al. Lung cancer operation with pulmonary angioplasty. Jpn J Bronchol 1992;14:123–128.
Lausberg HF, Graeter, TP, Tscholl D, Wendler O, Schafers HJ. Bronchovascular versus bronchial sleeve resection for lung tumors. Ann Thorac Surg 2005;79:1147–1152.
Okada M, Yamagishi H, Satake S, Matsuoka H, Miyamoto Y, Yoshimura M, et al. Survival related to lymph node involvement in lung cancer after sleeve lobectomy compared with pneumonectomy. J Thorac Cardiovasc Surg 2000;119:814–819.
Tronc F, Gregorie T, Rouleau J, Deslauriers J. Long-term results of sleeve lobectomy for lung cancer. Eur J Cardiothorac Surg 2000;17:550–556.
Vogt-Moykopf I, Fritz TH, Meyer G, Bulzerbruck H, Daskos G. Bronchoplastic and angioplastic operation in bronchial carcinoma: long-term results of a retrospective analysis from 1973–1983. Int Surg 1986;71:211–220.
Suen HC, Meyer BF, Guthrie T, Pohl MS, Sundaresan S, Roper DL, et al. Favorable results after sleeve lobectomy or bronchoplasty for bronchial malignancies. Ann Thorac Surg 1999;67:1557–1562.
Naruke T, Suematsu K, Ishikawa. Lymph node mapping and curability at various levels of metastasis in resected lung cancer. J Thorac Cardiovasc Surg 1978;76:832–839.
Wada H, Okubo K, Hirata T, Hitomi S. Evaluation of cases with combined bronchoplasty and pulmonary arterioplasty for the treatment of lung cancer. Lung Cancer 1995;13:113–120.
Nagayasu T, Matsumoto K, Tagawa T, Nakamura A, Yamasaki N, Nanashima A. Factors affecting survival after bronchoplasty and broncho-angioplasty for lung cancer: single institutional review of 147 patients. Eur J Cardiothorac Surg 2006;29:585–590.
Klemperer J, Ginsberg RL. Morbidity and mortality after pneumonectomy. Chest Surg Clin N Am 1999;9:512–525.
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;70:234–239.
Rendina EA, Venuta F, De Giacomo T, Flaishiman Isac, Fazi Paola, Ricci C. Safety and efficacy of bronchovascular reconstruction after induction chemotherapy for lung cancer. J Thorac Cardiovasc Surg 1997;114:830–835; discussion 835–7.
Bernard A, Ferrad L, Hagry O, Benoit L, Cheynel N, Favre JP. Identification of prognostic risk factors determining risk group for lung resection. Ann Thorac Surg 2000;70:1161–1171.
Ferguson MK, Lehman AG. Sleeve lobectomy or pneumonectomy: optimal management strategy using decision analysis techniques. Ann Thorac Surg 2003;76:1782–1788.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Yamashita, M., Komori, E., Sawada, S. et al. Pulmonary angioplastic procedure for lung cancer surgery. Gen Thorac Cardiovasc Surg 58, 19–24 (2010). https://doi.org/10.1007/s11748-009-0462-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11748-009-0462-9