Long-term results of sleeve lobectomy with continuous suture technique in non-small cell lung cancer

Yazgan, Serkan; Gürsoy, Soner; Üçvet, Ahmet; Yağcı, Tarık; Ünal, Mehmet; Samancılar, Özgür; Erbaycu, Ahmet Emin

doi:10.5606/tgkdc.dergisi.2019.16324

Cited by 2 publications

(2 citation statements)

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“…They also reported a morbidity of 4.36% and a five-year survival of 62.7% ( 31 ). Yazgan et al reported a five-year survival of 50.9%, a 30-day mortality of 1.2% and a 90-day mortality of 2.4% for a group of 80 patients ( 32 ). In patients undergoing open SL, Mayne et al reported a 5-year survival of 79%, a 30-day mortality of 4.5%, and a 90-day mortality of 6.8% ( 33 ).…”

Section: Discussionmentioning

confidence: 99%

Analyzing the impact of minimally invasive surgical approaches on post-operative outcomes of pneumonectomy and sleeve lobectomy patients

Nitsche¹,

Jordan²,

Demmy³

et al. 2023

J Thorac Dis

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Background: Some patients with non-small cell lung cancer (NSCLC) have superior short-and long-term outcomes with sleeve lobectomy rather than pneumonectomy. Originally sleeve lobectomy was reserved for patients with limited pulmonary function, however, the reported superior results allowed sleeve lobectomy to be performed in expanded patient populations. In a further attempt to improve post-operative outcomes surgeons have adopted minimally invasive techniques Minimally invasive approaches have potential benefits to patients such as decreased morbidity and mortality while maintaining the same caliber of oncologic outcomes. Methods:We identified patients at our institution who underwent sleeve lobectomy or pneumonectomy to treat NSCLC from 2007 to 2017. We analyzed these groups in respect to 30-and 90-day mortality, complications, local recurrence, and median survival. We included multivariate analysis to determine the impact of a minimally invasive approach, sex, extent of resection, and histology. Differences in mortality were analyzed using the Kaplan-Meier method using the log-rank test to compare the groups. A two-tailed Z test for difference in proportions was done to analyze complications, local recurrence, 30-day and 90-day mortality.Results: A total of 108 patients underwent sleeve lobectomy (n=34) or pneumonectomy (n=74) for treatment of NSCLC with 18 undergoing open pneumonectomy, 56 undergoing video-assisted thoracoscopic surgery (VATS) pneumonectomy, 29 undergoing open sleeve lobectomy, and 5 undergoing VATS sleeve lobectomy. There was no significant difference in 30-day mortality (P=0.064) but there was a difference in 90-day (P=0.007). There was no difference in complication rates (P=0.234) or local recurrence rates (P=0.779).The pneumonectomy patients had a median survival of 23.6 months (95% CI: 3.8-43.4 months). The sleeve lobectomy group had a median survival of 60.7 months (95% CI: 43.3-78.2 months) (P=0.008). On multivariate analysis extent of resection (P<0.001) and tumor stage (P=0.036) were associated with survival.There was no significant difference between the VATS approach and the open surgical approach (P=0.053).Conclusions: When considering patients undergoing surgery for NSCLC sleeve lobectomy resulted in lower 90-day mortality and better 3-year survival compared to patients undergoing PN. Having a sleeve lobectomy rather than a pneumonectomy and having earlier-stage disease lead to significantly improved survival on multivariate analysis. Having a VATS operation leads to a non-inferior post-operative outcome compared to open surgery.

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Section: Discussionmentioning

confidence: 99%

Analyzing the impact of minimally invasive surgical approaches on post-operative outcomes of pneumonectomy and sleeve lobectomy patients

Nitsche¹,

Jordan²,

Demmy³

et al. 2023

J Thorac Dis

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“…Бронхопластическая лобэктомия также связана с улучшением качества жизни за счёт сохранения паренхимы легких [2][3][4][5][6][7][8][9][10][11]. Однако проспективных рандомизированных исследований, сравнивающих бронхопластическую лобэктомию и пневмонэктомию, не проводилось [12][13][14][15][16][17]. Таким образом, идеальная хирургическая процедура для центрально расположенного НМРЛ оставалась спорной, а показания зависели от каждого случая и, в частности, от оперирующего хирурга.…”

Section: Introductionunclassified

Bronchoplatic surgery in the treatment of patients with nonsmall cell lung cancer

Аксарин¹,

Тер-Ованесов

Kopeyka³

2022

Sib. onkol. ž.

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Aim. To study the effect of organ-preserving bronchoplastic surgery on long-term treatment outcomes of patients with non-small cell lung cancer (NSCLC ).Material and Methods. The long-term results of surgical treatment of 740 patients with stage I–III NSCLC , who were treated in Ugra from 2002 to 2015, were analyzed. Lobectomy and bilobectomy were performed in 477 patients, and pneumonectomy was performed in 263 patients. Thirty-two patients underwent bronchoplastic lobectomy and bilobectomy. Intraoperative pathological frozen sections of lymph nodes (# 12) of the remaining lobe of the lung were examined in all patients. If metastases in these lymph nodes were not detected, we performed bronchoplastic lobectomy. If metastases in lymph nodes of the remaining lobe were detected, we performed pneumonectomy. The median age of the patients (only male patients) was 55.3 ± 9.9 years. In 19 (59.4 %) patients, sleeve resections were performed on the right side and in 13 (40.6 %) patients, these resections were performed on the left side. There were 15 bronchoplastic lobectomies of type A, 9 of type B, 4 of type C, and 4 of type D. Sleeve resection of the pulmonary artery was performed in 4 patients. In 16 cases (50.0 %), there were no regional metastases (pN0). In 10 (31.3 %) cases, there was pN1, in six – pN2 (18.7 %).Results. There were no cases of postoperative death. Late complications (asymptomatic bronchial stenosis) occurred in 3 (9.4 %) patients. Long-term treatment outcomes were better in patients who underwent organ-preserving bronchoplastic surgery than in patients who underwent pneumonectomy. Median survival was 66 months after bronchoplastic lobectomies and 34 months after pneumonectomies (p=0.01). The 5- and 10-year survival rates in patients who underwent bronchoplastic lobectomies were 52.9 % and 36.2 %, respectively. The corresponding values in patients who underwent pneumonectomies were 38.0 % and 31.9 %, respectively.Conclusion. Organ-preserving bronchoplastic surgery compared to pneumonectomy does not worsen long-term outcomes in patients with NSCLC .

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Long-term results of sleeve lobectomy with continuous suture technique in non-small cell lung cancer

Cited by 2 publications

References 24 publications

Analyzing the impact of minimally invasive surgical approaches on post-operative outcomes of pneumonectomy and sleeve lobectomy patients

Analyzing the impact of minimally invasive surgical approaches on post-operative outcomes of pneumonectomy and sleeve lobectomy patients

Bronchoplatic surgery in the treatment of patients with nonsmall cell lung cancer

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