Determining the appropriate sleeve lobectomy versus pneumonectomy ratio in central non-small cell lung cancer patients: an audit of an aggressive policy of pneumonectomy avoidance

Gómez-Caro, Abel; García, Samuel; Reguart, Noemı́; Cladellas, Esther; Arguis, Pedro; Sánchez, Marcelo; Gimferrer, Josep María

doi:10.1016/j.ejcts.2010.07.002

Cited by 54 publications

(51 citation statements)

References 24 publications

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“…According to our results, ESL is feasible and results in local disease control similar to that achieved with pneumonectomy but with mortality and major complication rates similar to those of classic sleeve lobectomies [8] and substantially lower than those for pneumonectomy [2,[14][15][16][17]. The functional value of the spared lung in our report and the analysis of our surgical technique particularly identify right-sided ESL (types A and D) with modified end-to-end bronchial anastomosis as a reliable option to avoid right pneumonectomy in selected indications.…”

Section: Commentsupporting

confidence: 59%

“…Larger resections or complete pneumonectomies were considered when faced with further submucosal NSCLC spread or macroscopic findings that were inconsistent with the viability of the spared lung or anastomotic sites. If needed, vascular reconstruction was performed as previously described [2], always after bronchial anastomosis.…”

Section: Preoperative Assessmentmentioning

confidence: 99%

“…Pneumonectomy causes a substantial decline in lung function and quality of life, precluding adjuvant treatment [1,2] or further lung resection when NSCLC develops in the remaining lung. In centrally located NSCLC, surgical intervention is thus a double-edged sword for multidisciplinary teams, raising doubts about the role of pneumonectomy in patient prognosis and health benefits.…”

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confidence: 99%

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Extended Sleeve Lobectomy: One More Step Toward Avoiding Pneumonectomy in Centrally Located Lung Cancer

Berthet

Paradela

Jiménez

et al. 2013

The Annals of Thoracic Surgery

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Section: Commentsupporting

confidence: 59%

Section: Preoperative Assessmentmentioning

confidence: 99%

mentioning

confidence: 99%

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Extended Sleeve Lobectomy: One More Step Toward Avoiding Pneumonectomy in Centrally Located Lung Cancer

Berthet

Paradela

Jiménez

et al. 2013

The Annals of Thoracic Surgery

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“…Overall survival following SL for patients with NSCLC ranges from 39-53% at five years and 28-34% at ten years (4,5,12,16,18,19,23). SL is technically more demanding than PN, and the decision to select this procedure may be influenced by the surgeons' experience.…”

Section: Discussionmentioning

confidence: 99%

For non-small cell lung cancer with T3 (central) disease, sleeve lobectomy or pneumonectomy?

Ma¹,

Guo²,

Shu³

et al. 2016

J. Thorac. Dis.

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Background: Pneumonectomy (PN) has traditionally been the treatment of choice for central lung tumors for which the alternative is sleeve lobectomy (SL). The aim of this study was to compare early and long-term results after SL and PN in focusing on T3 central non-small cell lung cancer (NSCLC). Methods:Patients who underwent SL (n=58) or PN (n=42) were retrospectively analyzed. For bias reduction, these 100 patients had been selected according to the following criteria: (I) tumor located in the main bronchus less than 2 cm distal to the carina; (II) there were no N2 disease; (III) no induction therapy was applied; (IV) complete resection (R0) was achieved. It is an adequate oncologic resection and should be treated as the first line intervention whenever complete resection can be achieved.

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“…The present authors favour the use of interrupted sutures of 4/0 monofilament absorbable material (1,10). However, the employment of continuous running suture (complete or partial) has been described by others (11,12).…”

Section: Right Upper Sleeve Lobectomymentioning

confidence: 99%

Current Role of Bronchoplastic Procedure for Lung Cancer

D’Andrilli¹,

Maurizi²,

Venuta³

et al. 2012

Toraks Cer Bult

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The indication for a sleeve resection is well established: a tumor arising at the origin of a lobar bronchus but not infiltrating as far as to require pneumonectomy. In addition, a sleeve resection may be indicated when N1 nodes infiltrate the bronchus from the outside, as is often the case in the left upper lobe tumors. From a functional point of view, sleeve lobectomy is strictly indicated in patients who cannot withstand pneumonectomy, but recent experiences have shown that the advantages of sparing lung parenchyma are evident also in patients without cardio-pulmonary impairment. Most studies show similar or better survival results for parenchymal sparing resections if compared with pneumonectomy. Moreover, in the analysis of 5-year survival according to stage, sleeve lobectomy results in higher survival rates for stage I, II. The survival advantage in stage III appears to be limited and the benefit is not always confirmed for stage III-N2 patients. Postoperative morbidity and mortality data reveal overall better results for patients undergoing sleeve lobectomy with respect to pneumonectomy. The preservation of lung parenchyma has been indicated by some authors as the possible cause of a theoretical increased risk for locoregional recurrence after sleeve lobectomy. However, although in some experiences a higher local recurrence rate is reported for sleeve resection with advanced nodal status (N2), the few studies analysing risk factors for recurrence, show that the tumor stage and the nodal status are the only negative predictive factors, rather than the type of operation performed.

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Determining the appropriate sleeve lobectomy versus pneumonectomy ratio in central non-small cell lung cancer patients: an audit of an aggressive policy of pneumonectomy avoidance

Cited by 54 publications

References 24 publications

Extended Sleeve Lobectomy: One More Step Toward Avoiding Pneumonectomy in Centrally Located Lung Cancer

Extended Sleeve Lobectomy: One More Step Toward Avoiding Pneumonectomy in Centrally Located Lung Cancer

For non-small cell lung cancer with T3 (central) disease, sleeve lobectomy or pneumonectomy?

Current Role of Bronchoplastic Procedure for Lung Cancer

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