Background: Sleeve resection is a widely performed type of operation in the surgical treatment of non–small cell lung cancer. Video-assisted thoracoscopic surgery (VATS) is now used even in central tumor surgeries of the lung with the increasing technology and experience. Sleeve resection cases performed through VATS in our clinic in recent years were presented with demographic, surgical, pathologic, and survey characteristics. Materials and Methods: Twelve patients who underwent sleeve resection with VATS in our clinic between November 2015 and August 2019 were included in the study. Operative, pathologic, and postoperative characteristics of the patients were examined. Results: A total of 12 patients, 3 female and 9 male individuals, were included in the study. The mean age of the patients was 61.7±12.9 years. According to the localization of the tumors, left upper lobectomy was performed in 4 patients and 8 patients underwent right upper lobectomy. During the sleeve anastomosis of the patients, 3/0 prolene sutures were used in 5 patients (36%) and 4/0 prolene sutures in 4 patients (36%), whereas 3/0 polydioxanone suture (PDS) was used in 3 patients (28%). The mean operation time was 288.2±77.1 (205 to 460) minutes and the mean anastomosis time was 70±18.5 (55 to 110) minutes. In the postoperative period, 1 patient who had acute myocardial infarction died on the fourth postoperative day. The mean postoperative drainage duration of the patients was 5.5±1.9 (3 to 10) days and the mean length of hospital stay was 6.4±1.9 (4 to 11) days. When the pathologic features were examined, the mean tumor diameter was found to be 2.5±1.2 (1 to 5.5) cm. The mean follow-up period was calculated as 26.1±15.6 months (2 to 47). Other than 1 patient who died, the follow-up of 11 patients still proceeds. Conclusions: VATS approach of sleeve resections, which is performed cautiously even by thoracotomy, is becoming more common. These operations, which could be performed in experienced centers, offer a postoperative period of less morbidity to the patients with the advantage of reduced postoperative pain, drainage time, and hospital stay.

Bu çalışmada papiller baskın histolojik alt tipin akciğer adenokarsinomunda sağkalımı kötü etkileyip etkilemediği araştırıldı. Ça lış ma pla nı:Ocak 2005 -Aralık 2016 tarihleri arasında kliniğimizde ameliyat olan papiller baskın alt tipli akciğer adenokarsinomlu toplam 80 hasta (70 erkek, 10 kadın; ort. yaş 60.7 yıl; dağılım 42-79 yıl) çalışmaya alındı. Bu hastalar lepidik, asiner ve müsinöz alt tipler ile karşılaştırıldı. Genel ve beş yıllık sağkalım oranları değerlendirildi. Bul gu lar:Beş yıllık sağkalım papiller baskın histolojik alt tipte %40.5 iken, bu oran lepidik, asiner ve müsinöz alt tiplerde sırasıyla %70.9, %59.0 ve %66.6 idi. Papiller alt tipin sağkalımı lepidik (p= 0.002), asiner (p= 0.008) ve müsinöz (p= 0.0048) alt tiplere kıyasla, anlamlı düzeyde daha kötü idi. Bu durum, Evre 1 hastalıkta daha belirgindi (papiller %47.5, lepidik: %86.9 [p= 0.001], asiner %69.3 [p= 0.040] ve müsinöz %90.0 [p= 0.050]).So nuç: Çalışma sonuçlarımız papiller baskın alt tipin akciğer adenokarsinomunda sağkalımı kötü etkilediğini ve bu olguların, hastalığın erken evrelerinde dahi, adjuvan tedavi yöntemleri için aday olabileceğini göstermektedir.

Background:Predominant histologic subtypes have been reported as predictors of survival of patients with pulmonary adenocarcinoma.Aims:To evaluate the predictive value of histologic classification in resected lung adenocarcinoma using the classification systems proposed by the International Association for the Study of Lung Cancer, American Thoracic Society, European Respiratory Society, and World Health Organization (2015).Study Design:Cross-sectional study.Methods:The histologic classification of a large cohort of 491 patients with resected lung adenocarcinoma (stages I-III) was retrospectively analyzed. The tumors were classified according to their predominant component (lepidic, acinar, papillary, solid, micropapillary, and mucinous), and their predictive values were assessed for clinicopathologic characteristics and overall survival.Results:The patient cohort comprised 158 (32.2%) patients with solid predominant, 150 (30.5%) with acinar predominant, 80 (16.3%) with papillary predominant, 75 (15.3%) with lepidic predominant, 22 (4.5%) with mucinous, and 5 (1.0%) with micropapillary subtype, and 1 (0.2%) with adenocarcinoma in situ. Overall 5-year survival of 491 patients was found to be 51.8%. Patients with lepidic, acinar, and mucinous adenocarcinoma had 70.9%, 59.0%, and 66.6% 5-year survival, respectively, and there was no statistically significant difference between them. Whereas patients with solid, papillary, and micropapillary predominant adenocarcinoma had 41.0%, 40.5%, and 0.0% 5-year survival, respectively. Compared to other histologic subtypes, patients with solid and papillary predominant adenocarcinoma had significantly lower survival than those with lepidic (p<0.001, p=0.002), acinar (p<0.001, p=0.008), and mucinous (p=0.048, p=0.048) subtypes, respectively. The survival difference between patients with solid subtype and those with papillary subtype was not statistically significant (p=0.67).Conclusion:Solid and papillary histologic subtypes are poor prognostic factors in resected invasive lung adenocarcinoma.