Early postoperative results of our patients who underwent bronchial sleeve lobectomy

Abstract

Objective: Sleeve resections of the lung are a surgical technique for complete resection of benign or malignant diseases of the airway while preserving as much intact lung parenchyma as possible. The aim of this study is to review the clinical, radiologic and histopathologic features and early complications of patients who underwent bronchial sleeve lobectomy for non-small cell lung carcinoma (NSCLC) in the last 10 years. Materials and Methods: The study included 19 patients who underwent bronchial sleeve lobectomy for NSCLC. Age, gender, smoking, comorbidity, respiratory test, histopathological type, tumor localization, surgery, mediastinal staging, hospital stay, intensive care unit stay and early postoperative complications were recorded. Results: The mean age of our patients who underwent bronchial sleeve lobectomy was 55.5 years (46-67). Sixteen (84.2%) of our patients were male and 3 (15.7%) were female. The histopathological diagnosis of our patients who underwent bronchial sleeve lobectomy for NSCLC was squamous cell carcinoma in 10 (52.6%), adenocarcinoma in 5 (26.3%), large cell carcinoma in 2 (10.5%) and atypical carcinoid tumor in 2 (10.5%). Postoperative complications included atelectasis in 3 patients, prolonged air leak in 3 patients, pneumonia in 2 patients and anastomotic stenosis in 1 patient. Conclusion: Bronchial sleeve lobectomy is a safe, parenchyma-sparing procedure with low mortality and morbidity. We think that preoperative smoking cessation is the most effective method to prevent postoperative secretion retention.

Keywords

• Sleeve llobectomy
• Lung carcinom
• complications

Bronşiyal sleeve lobektomi uygulanan olgularımızın postoperatif erken dönem sonuçları

Abstract

Sleeve resections of the lung are a surgical technique for the complete resection of benign or malignant diseases of the airway while preserving as much intact lung parenchyma as possible. This study aims to review the clinical, radiologic, and histopathologic features and early complications of patients who underwent bronchial sleeve lobectomy for non-small cell lung carcinoma (NSCLC) in the last 10 years. The study included 19 patients who underwent bronchial sleeve lobectomy for NSCLC. Age, gender, smoking, comorbidity, respiratory test, histopathological type, tumor localization, surgery, mediastinal staging, hospital stay, intensive care unit stay, and early postoperative complications were recorded. The mean age of our patients who underwent bronchial sleeve lobectomy was 55.5 years (46-67). Sixteen (84.2%) of our patients were male and 3 (15.7%) were female. The histopathological diagnosis of our patients who underwent bronchial sleeve lobectomy for NSCLC was squamous cell carcinoma in 10 (52.6%), adenocarcinoma in 5 (26.3%), large cell carcinoma in 2 (10.5%) and atypical carcinoid tumor in 2 (10.5%). Postoperative complications included atelectasis in 3 patients, prolonged air leak in 3 patients, pneumonia in 2 patients, and anastomotic stenosis in 1 patient. Bronchial sleeve lobectomy is a safe, parenchyma-sparing procedure with low mortality and morbidity. We think that preoperative smoking cessation is the most effective method to prevent postoperative secretion retention.

Keywords

• Sleeve lobektomi
• akciğer kanseri
• komplikasyonlar

References

1. 1. Kalaycı G, Dilege Ş, Toker A, Tanju S, Ziyade S, Bayrak Y, and Yılmaz D. Sleeve resections: An evaluation of 77 patients. Turkish Journal of Thoracic and Cardiovascular Surgery, 2005: 13(4);397-402.
2. 2. Mısırlıoglu AK, Alpay L, Kanbur S, Kosar A, Sonmez H, Demir M, and Tulay ÖR. Akciğer kanserinin cerrahi tedavisinde sleeve rezeksi-yonlarının yeri. Maltepe Tıp Dergisi, 2013:5(2):5-13.
3. 3. Abdelsattar ZM, Shen KR, Yendamuri S, Cassivi S, Nichols FC 3rd, Wigle DA, et al. Outcomes after sleeve lung resections versus pneumonec-tomy in the United States. Ann Thorac Surg. 2017;104:1656-1664.
4. 4. Pages PB, Mordant P, Renaud S, Brouchet L, Thomas PA, Danham M, et al. Sleeve lobectomy may provide better outcomes than pneumonectomy for non–small cell lung cancer. A decade in a nationwide study. J Thorac Cardiovasc Surg. 2017;153:184-195.
5. 5. Chen J, Soultanis KM, Sun F, Gonzalez-Rivas D, Duan L, Wu L, Jiang L, Zhu Y, and Jiang G.J. Outcomes of sleeve lobectomy versus pneumonectomy: A propensity score-matched study. Thorac Cardiovasc Surg. 2021;162(6):1619-1628.
6. 6. Nakagawa K, Yoshida Y, Yotsukura M, et al. Minimally invasive open surgery (MIOS) for clinical stage I lung cancer: diversity in minimally invasive procedures. Jpn J Clin Oncol 2021;51:1649-1655.
7. 7. Gao HJ, Jiang ZH, Gong L, et al. Video-Assisted Vs Thoracotomy Sleeve Lobectomy for Lung Cancer: A Propensity Matched Analysis. Ann Thorac Surg 2019;108:1072-1079.
8. 8. Xie D, Deng J, Gonzalez-Rivas D, et al. Comparison of video-assisted thoracoscopic surgery with thoracotomy in bronchial sleeve lobectomy for centrally located non-small cell lung cancer. J Thorac Cardiovasc Surg 2021;161:403- 413.e2.

9. 9. Kambam JR, Chen L, and Turner ME. Effect of smoking and oxy-hemoglobin dissociation curve. Anaesthesiology 1982:57;492-496.
10. 10. Tedder M, Anstadt MP, Tedder SD, and Lowe JE. Current morbidity, mortality, and survival after bronchoplastic procedures for malignancies. Ann Thorac Surg, 1992; 54:387-391.
11. 11. De Leyn P, Rots W, Deneffe G, Nafteux P, Coo-semans W, Van Raemdonck D, Decker G, Le-rut, T. Sleeve lobectomy for non-small cell lung cancer. Acta Chirurgica Belgica, 2003:103(6);570–576.
12. 12. Mehran RJ, Deslauries J, Piraux M, Beaulıeu M, Guimont C, and Brisson J. Survival related to nodal status after sleeve resection for lung cancer. J Thorac Cardiovasc Surg, 1994;107:576-583.
13. 13. Van Schil PE, Brutel RA, Knaepen PJ, Van Swieten H, Reher SW, Goossens DJ, et al. Long-term survival after bronchial sleeve resection: univariate and multivariate analyses. Ann Thorac Surg, 1996;61:1087-1091.