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The role of sleeve resections in surgical treatment of lung cancer

Year 2013, Volume: 5 Issue: 2, 5 - 13, 01.08.2013

Abstract

Aim: Bronchial sleeve resections are developed as alternative techniques to pneumonectomy operation in malignant and benign pathologies of the lung. Patients and Methods: This study was carried out between September 1994 and May 2009 in order to examine 71 patients who underwent sleeve resection in Istanbul Sureyyapasa Chest Surgery Center. Results: Twenty-six of the patients died in long term follow-up, mean and maximum follow-up duration was 33 months and 120 months, respectively. Standard deviation was 27.7. General survival rate in two years was 67.2% mean 57.3±7.5 months . With the development of complications; the relationships between operation side, anastomosis technique seperate, continuous suture , patients' age were investigated, however statistically significant results were found p=0.09, p=0.4, p=0.3, respectively . The effect on survival was investigated between right and left sided operation, no significant results were found statistically p=0.13 . When survival rates were analysed according to the presence of complications; better statistical results were found, however still with no statistical significance p= 0.08 . It was statistically significant that survival rates were affected by additional surgical procedures p= 0.03 . It was also statistically significant that N factor, which was divided into three groups: N0, N1 and N2, had an influence on survival p=0.03 . The two-year survival rate was 81.5% in N0, 63% in N1, 21% in N2. There was no statistically significant effect on survival by tumor diameters p=0.6 . Conclusion: Sleeve resections can be performed with low mortality and morbidity rates like other resections.

References

  • Frist WH, Mathisen DJ, Hilgenberg AD, Grillo HC: Bronchial sleeve resection with and without pulmonary resoction. J Thorac Cardiovasc Surg 1987; 93:350-357.
  • Belli L, Meroni A, Rodinara G, Bcati CA: Bron- choplastis procedures and pulmonary artery re- construction in the treatment of bronchogenic cancer. J Thorac Cardiovasc Surg; 1985 90:167- 171.
  • Suen HC, Meyers BF, Guithrie T. Favorable re- sults after sleeve lobectomy or bronchoplasty for bronchial malignancies.Ann Thorac Surg 1999;67:1557-1562.
  • Tsuchiya R. Bronchoplastic bronchovascular tech- niques. In: Pearson FG, Deslauriers J,Ginsberg RJ, Hiebert CA, McKneally MF, Ursche HC, editors. Thoracic surgery. Philadelphia: Churchill Livings- tone, 1995: 870-878.
  • Van Schil et al. Completion pneumonectomy af- ter bronchial sleeve resection: Incidence, indicati- ons and results Ann Thorac Surg 1992;53: 1042- 1045.
  • McGovern EM, Trastek VF, Pairolero PC, Payne S. Completion pneumonectomy:Indications, complications, and results. Ann Thorac Surg 1988;46:141-146.
  • Filip E. Muysoms FE, De La Rivière AB, Defauw JJ, Dossche KM, Knaepen PJ, Van Den Bosch JM. Completion pneumonectomy: analysis of ope- rative mortality and survival. Ann Thorac Surg 1998; 66: 1165-1169.
  • James R, Miller D, Nagorney DM, Allen MS, Des- champs C, Trastek VF, Pairolero PC. Surgical treat- ment of hepatic and pulmonary metastases from colon cancer. Ann Thorac Surg 2001;71:975- 980.Cerfolio RJ. The incidence, etiology and pre- vention of postresectional bronchopleural fistula. Semin Thorac Cardiovasc Surg 2001;13:3-7.
  • Muysoms FE, de la Riviere AB, Defauw JJ et al. Completion pneumonectomy: analysis of operative mortality and survival. Ann Thorac 1998;66:1165-1169.
  • Asamura H, Naruke T, Tsuchiya R, Goya T, Kon- do H, Suemasu K. Bronchopleural fistulas asso- ciated with lung cancer operations. Univariate and multivariate analysis of risk factors, mana- gement, and outcome. J Thorac Cardiovasc Surg 1992;104:1456 - 1464.
  • Sonobe M, Nakagawa M, Ichinose M, Ikegami N, Nagasawa M, Shindo T. Analysis of risk factors in bronchopleural fistula after pulmonary resection for primary lung cancer. Eur J.Cardiothorac Surg 2000;18:519-523.
  • Hollaus PH, Janakiev D, Pridun NS. Telescope anastomosis in bronchial sleeve resections with high-caliber mismatch. Ann Thorac Surg 2001; 72(2): 357-361.
  • Hollaus PH, Janakiev D, Pridun NS. Telescope anastomosis in bronchial sleeve resections with high-caliber mismatch. Ann Thorac Surg 2001; 72(2): 357-361.
  • Okada M, Tsubota N, Yoshimura M, Miyamoto Y, Matsuoka H, Satake S, Yamagishi H. Extended sleeve lobectomy for lung cancer: the avoidan- ce of pneumonectomy. J Thorac Cardiovasc Surg 1999; 118(4):710-714.
  • Pretreatment evaluation of nonsmall cell lung cancer. American Thoracic Society/Europan Res- piratory Society. 1997 : 320-332.
  • Mehran RJ, Deslauriers J, Piraux M, Beaulieu M, Guimont C, Brisson J. Survival related to nodal status after sleeve resection for lung cancer. J Thorac Cardiovasc Surg. 1994; 107(2): 576-583.
  • Lausberg HF, Graeter TP, Wendler O, Demertzis S, Ukena D, Schafers HJ. Bronchial and broncho- vascular sleeve resection for treatment of central lung tumors. Ann Thorac Surg. 2000; 70(2): 367- 372.
  • Terzi A, Lonardoni A, Falezza G, Furlan G, Scana- gatta P, Pasini F, Calabro F. Sleeve lobectomy for non-small cell lung cancer and carcinoids: results in 160 cases. Eur J Cardiothorac Surg 2002; 59 Deslauriers J, Mehran RJ, Gulmont C, Brisson J Sta- ging and management of lung cancer: sleeve rese- ction. World J Surg 1993 Nov-Dec;17(6):712-718.
  • Naruke T., Tsuchiya R, Kondo H, Asamura H. Prog- nosis and survival after resection for bronchogenic carcinoma based on the 1997 TNM-Staging classifi- cation: The Japanese Experience. Ann.Thorac. Surg. 2001;71:1759-1764.
  • Yamamoto K, Miyamoto Y, Ohsumi A, Kojima F; Sle- eve Lung Resection for lung cancer: Analysis accor- ding to the type of procedure J Thorac Cardiovasc Surg 2008;136:1349-1356.
  • Okada M, Yamagishi H, Satake S, Matsuoka H, Mi- yamoto Y, Yoshimura M, Tsubota N. Survival related to lymph node involvement in lung cancer after sle- eve lobectomy compa-red with pneumonectomy. J Thorac Cardiovasc Surg2000; 119(4): 814-819.
  • Massard G, Kessler R, Gasser B, Ducrocq X, Elia S, Gouzou S et al. Local control of disease and survi- val following bronchoplastic lobectomy for non- small cell lung cancer. Eur J Cardiothorac Surg 1999;16:276-282.
  • Van Schil PE, Brutel de la Riviere A, Knaepen PJ, Van Swieten HA, Reher SW, Goossens DJ et al. Long- term survival after bronchial sleeve resection: uni- variate and multivariate analyses. Ann Thorac Surg 1996;61:1087-1091.
  • Ferguson MK, Lehman AG. Sleeve lobectomy or pneumonectomy: optimal management strategy using decision analysis techniques. Ann Thorac Surg 2003;76:1782-1788.
  • Yavuzer Ş, Kutlay H, Özdemir N, Akal M. Bronşial sle- eve rezeksiyon bronkoplastik yöntemler. A Ü Tıp Fak Mec 1993;46:129-140.
  • Metin M, Sayar A, Demir A, Kutlu CA, Turna A, Ölç- men A ve ark. Sleeve rezeksiyonlar: anastomoz tek- nikleri, morbidite, mortalite. Türk Göğüs Kalp Damar Cer Derg 2001;9:160-162.
  • Kalaycı G, Dilege Ş, Toker A,Tanju S, Ziyade S, Bayrak Y, Yılmazbayhan D. Sleeve Rezeksiyonları: 77 Olgu- nun Değerlendirilmesi, Türk Göğüs Kalp Damar Cer Derg 2005; 13:397-340.
  • Yildızeli B, Fadel E, Mussot S, Fabre D, Chataigner O, Dartavelle PG. Morbidity, mortality, and long term survival after sleeve lobectomy for non-small cell lung cancer. Eur J Cardiothorac Surg. 2007;31:95- 102.

Akciğer kanserinin cerrahi tedavisinde sleeve rezeksiyonlarının yeri

Year 2013, Volume: 5 Issue: 2, 5 - 13, 01.08.2013

Abstract

Amaç: Bronşial sleeve rezeksiyonlar akciğerin habis ve selim patolojilerinde pnömonektomi operasyonunun alternatifi olarak geliştirilmiş tekniklerdir. Gereç ve Yöntem: Bu çalışma İstanbul Süreyyapaşa Göğüs Cerrahi merkezinde Eylül 1994- Mayıs 2009 tarihleri arasında 71 hastaya uygulanan sleeve rezeksiyonları incelemek amacıyla yapılmıştır. Bulgular: Uzun dönem takipte sleeve rezeksiyon uygulanan hastalardan 26'sı kaybedildi, ortalama takip süresi 33 ay, maksimum takip süresi 120 aydı. Standart sapması 27.7 olarak bulundu. İki yıllık sağkalım %67.2 ort.57.3 ay±7.5 olarak saptandı.Komplikasyonların ortaya çıkmasıyla; operasyon yapılan taraf, anastomoz şekli tek- tek, devamlı sütür , olguların yaşı arasındaki ilişki araştırıldı ancak istatistiksel olarak anlamlı bir sonuç bulunamadı. Sırasıyla; p=0.09, p=0.4, p=0.3 .Operasyon tarafının sağ ya da sol olmasının sağkalıma etkisi araştırıldığında istatistiksel olarak anlamlı bir sonuç bulunamadı p=0.13 . Sağ kalım oranlarını, komplikasyonların varlığına göre değerlendirdiğimizde istatistiksel olarak anlamlı olmamakla birlikte, anlamlıya yakın sonuç elde edildi p= 0.08 . Sağkalım oranlarının, uygulanan ek cerrahi işlemlerden etkilendiği istatistiksel olarak anlamlı bulundu p= 0.03 . N faktörü; N0, N1 ve N2 olmak üzere üç ayrı gruba ayrıldı ve sağkalıma etkisi araştırıldı ve istatistiksel olarak anlamlı bulundu p= 0.03 . 2 yıllık sağkalım N0'da % 81.5, N1'de % 63, N2'de % 21 olarak bulundu. Tümör çaplarının sağkalıma etkisi istatistiksel olarak anlamlı bulunmadı p=0.6 Sonuç: Sleeve rezeksiyonlar diğer rezeksiyonlar gibi düşük mortalite ve morbidite ile yapılabilir.

References

  • Frist WH, Mathisen DJ, Hilgenberg AD, Grillo HC: Bronchial sleeve resection with and without pulmonary resoction. J Thorac Cardiovasc Surg 1987; 93:350-357.
  • Belli L, Meroni A, Rodinara G, Bcati CA: Bron- choplastis procedures and pulmonary artery re- construction in the treatment of bronchogenic cancer. J Thorac Cardiovasc Surg; 1985 90:167- 171.
  • Suen HC, Meyers BF, Guithrie T. Favorable re- sults after sleeve lobectomy or bronchoplasty for bronchial malignancies.Ann Thorac Surg 1999;67:1557-1562.
  • Tsuchiya R. Bronchoplastic bronchovascular tech- niques. In: Pearson FG, Deslauriers J,Ginsberg RJ, Hiebert CA, McKneally MF, Ursche HC, editors. Thoracic surgery. Philadelphia: Churchill Livings- tone, 1995: 870-878.
  • Van Schil et al. Completion pneumonectomy af- ter bronchial sleeve resection: Incidence, indicati- ons and results Ann Thorac Surg 1992;53: 1042- 1045.
  • McGovern EM, Trastek VF, Pairolero PC, Payne S. Completion pneumonectomy:Indications, complications, and results. Ann Thorac Surg 1988;46:141-146.
  • Filip E. Muysoms FE, De La Rivière AB, Defauw JJ, Dossche KM, Knaepen PJ, Van Den Bosch JM. Completion pneumonectomy: analysis of ope- rative mortality and survival. Ann Thorac Surg 1998; 66: 1165-1169.
  • James R, Miller D, Nagorney DM, Allen MS, Des- champs C, Trastek VF, Pairolero PC. Surgical treat- ment of hepatic and pulmonary metastases from colon cancer. Ann Thorac Surg 2001;71:975- 980.Cerfolio RJ. The incidence, etiology and pre- vention of postresectional bronchopleural fistula. Semin Thorac Cardiovasc Surg 2001;13:3-7.
  • Muysoms FE, de la Riviere AB, Defauw JJ et al. Completion pneumonectomy: analysis of operative mortality and survival. Ann Thorac 1998;66:1165-1169.
  • Asamura H, Naruke T, Tsuchiya R, Goya T, Kon- do H, Suemasu K. Bronchopleural fistulas asso- ciated with lung cancer operations. Univariate and multivariate analysis of risk factors, mana- gement, and outcome. J Thorac Cardiovasc Surg 1992;104:1456 - 1464.
  • Sonobe M, Nakagawa M, Ichinose M, Ikegami N, Nagasawa M, Shindo T. Analysis of risk factors in bronchopleural fistula after pulmonary resection for primary lung cancer. Eur J.Cardiothorac Surg 2000;18:519-523.
  • Hollaus PH, Janakiev D, Pridun NS. Telescope anastomosis in bronchial sleeve resections with high-caliber mismatch. Ann Thorac Surg 2001; 72(2): 357-361.
  • Hollaus PH, Janakiev D, Pridun NS. Telescope anastomosis in bronchial sleeve resections with high-caliber mismatch. Ann Thorac Surg 2001; 72(2): 357-361.
  • Okada M, Tsubota N, Yoshimura M, Miyamoto Y, Matsuoka H, Satake S, Yamagishi H. Extended sleeve lobectomy for lung cancer: the avoidan- ce of pneumonectomy. J Thorac Cardiovasc Surg 1999; 118(4):710-714.
  • Pretreatment evaluation of nonsmall cell lung cancer. American Thoracic Society/Europan Res- piratory Society. 1997 : 320-332.
  • Mehran RJ, Deslauriers J, Piraux M, Beaulieu M, Guimont C, Brisson J. Survival related to nodal status after sleeve resection for lung cancer. J Thorac Cardiovasc Surg. 1994; 107(2): 576-583.
  • Lausberg HF, Graeter TP, Wendler O, Demertzis S, Ukena D, Schafers HJ. Bronchial and broncho- vascular sleeve resection for treatment of central lung tumors. Ann Thorac Surg. 2000; 70(2): 367- 372.
  • Terzi A, Lonardoni A, Falezza G, Furlan G, Scana- gatta P, Pasini F, Calabro F. Sleeve lobectomy for non-small cell lung cancer and carcinoids: results in 160 cases. Eur J Cardiothorac Surg 2002; 59 Deslauriers J, Mehran RJ, Gulmont C, Brisson J Sta- ging and management of lung cancer: sleeve rese- ction. World J Surg 1993 Nov-Dec;17(6):712-718.
  • Naruke T., Tsuchiya R, Kondo H, Asamura H. Prog- nosis and survival after resection for bronchogenic carcinoma based on the 1997 TNM-Staging classifi- cation: The Japanese Experience. Ann.Thorac. Surg. 2001;71:1759-1764.
  • Yamamoto K, Miyamoto Y, Ohsumi A, Kojima F; Sle- eve Lung Resection for lung cancer: Analysis accor- ding to the type of procedure J Thorac Cardiovasc Surg 2008;136:1349-1356.
  • Okada M, Yamagishi H, Satake S, Matsuoka H, Mi- yamoto Y, Yoshimura M, Tsubota N. Survival related to lymph node involvement in lung cancer after sle- eve lobectomy compa-red with pneumonectomy. J Thorac Cardiovasc Surg2000; 119(4): 814-819.
  • Massard G, Kessler R, Gasser B, Ducrocq X, Elia S, Gouzou S et al. Local control of disease and survi- val following bronchoplastic lobectomy for non- small cell lung cancer. Eur J Cardiothorac Surg 1999;16:276-282.
  • Van Schil PE, Brutel de la Riviere A, Knaepen PJ, Van Swieten HA, Reher SW, Goossens DJ et al. Long- term survival after bronchial sleeve resection: uni- variate and multivariate analyses. Ann Thorac Surg 1996;61:1087-1091.
  • Ferguson MK, Lehman AG. Sleeve lobectomy or pneumonectomy: optimal management strategy using decision analysis techniques. Ann Thorac Surg 2003;76:1782-1788.
  • Yavuzer Ş, Kutlay H, Özdemir N, Akal M. Bronşial sle- eve rezeksiyon bronkoplastik yöntemler. A Ü Tıp Fak Mec 1993;46:129-140.
  • Metin M, Sayar A, Demir A, Kutlu CA, Turna A, Ölç- men A ve ark. Sleeve rezeksiyonlar: anastomoz tek- nikleri, morbidite, mortalite. Türk Göğüs Kalp Damar Cer Derg 2001;9:160-162.
  • Kalaycı G, Dilege Ş, Toker A,Tanju S, Ziyade S, Bayrak Y, Yılmazbayhan D. Sleeve Rezeksiyonları: 77 Olgu- nun Değerlendirilmesi, Türk Göğüs Kalp Damar Cer Derg 2005; 13:397-340.
  • Yildızeli B, Fadel E, Mussot S, Fabre D, Chataigner O, Dartavelle PG. Morbidity, mortality, and long term survival after sleeve lobectomy for non-small cell lung cancer. Eur J Cardiothorac Surg. 2007;31:95- 102.
There are 28 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Aysun Kosif Mısırlıoğlu This is me

Levent Alpay This is me

Serda Kanbur This is me

Altuğ Koşar This is me

Hakan Sönmez This is me

Mine Demir This is me

Volkan Baysungur This is me

İrfan Yalçınkaya This is me

Tülay Örki This is me

Publication Date August 1, 2013
Published in Issue Year 2013 Volume: 5 Issue: 2

Cite

Vancouver Kosif Mısırlıoğlu A, Alpay L, Kanbur S, Koşar A, Sönmez H, Demir M, Baysungur V, Yalçınkaya İ, Örki T. Akciğer kanserinin cerrahi tedavisinde sleeve rezeksiyonlarının yeri. Maltepe tıp derg. 2013;5(2):5-13.