Postoperative complications after bronchoplastic procedures in the treatment of bronchial malignancies1

Krüger, M.; Uschinsky, K; Hassler, Kenneth R.; Engelmann, C

doi:10.1016/s1010-7940(98)00143-2

Cited by 34 publications

(22 citation statements)

References 10 publications

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“…22 It is due to sputum retention secondary to edema at the anastomosis and mucociliary dysfunction related to mucosal interruption and denervation of the reimplanted lobe(s). It occurs more often after sleeve resection of the lower lobes (where anastomotic kinking is potentially the greatest) and less often after sleeve resection of the upper lobes (where the distal bronchial lumen is made wider to meet the size of the proximal lumen).…”

Section: Morbidity and Mortalitymentioning

confidence: 99%

“…22 This complication can generally be avoided if one applies the surgical principles involved during construction of a healthy anastomosis, including avoidance of nodal overdissection and unnecessary devascularization, careful approximation of the bronchial ends, and most importantly wrapping the anastomosis with a pedicled intercostal fl ap if the anastomosis is considered to be at risk of dehiscence. 23 The operative mortality associated with bronchoplasties should be <5% ( Table 1).…”

Section: Morbidity and Mortalitymentioning

confidence: 99%

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History and current status of bronchoplastic surgery for lung cancer

Deslauriers

Tronc

Grégoire

2009

Gen Thorac Cardiovasc Surg

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Sleeve lobectomy for carcinoma of the lung was first described as a compromised operation for patients whose pulmonary reserve was considered inadequate to permit pneumonectomy. Since then, many authors have suggested that bronchoplasties may provide as good if not better results than pneumonectomy in selected cases of primary carcinoma of the lung involving the proximal bronchial tree. In all reported series, lesions in the hilum of the right upper lobe are the commonest indication for sleeve lobectomy, although all lobes and segments of the lungs may on occasion be involved with tumors that are amenable to some form of lung-sparing bronchoplastic procedure. As a general statement, bronchoplasties should be considered in any case of lung cancer that can be completely resected by these techniques although some controversy persists about the application of these procedures in patients with N(1) or N(2) disease. Published reports document a 30-day operative mortality of 0%-5%. Complications peculiar to sleeve lobectomy are an increased incidence of retained secretions, bronchovascular fistulas, and a potential for an increased incidence of local recurrence. Most major reports document a 5-year survival of 40%-50% and functional results that are significantly better than those obtained following pneumonectomy.

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Section: Morbidity and Mortalitymentioning

confidence: 99%

Section: Morbidity and Mortalitymentioning

confidence: 99%

History and current status of bronchoplastic surgery for lung cancer

Deslauriers

Tronc

Grégoire

2009

Gen Thorac Cardiovasc Surg

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“…Park et al reported that the incidence of bronchial stenosis and the rate of BPF were 2.6 and 1.5 , respectively in 191 patients who underwent wedge bronchoplastic 4 . In another comparative study of sleeve lobectomy and wedge lobectomy, wedge lobectomy has been reported as a useful bronchoplastic procedure in terms of safety, prognosis, and postoperative respiratory function [5][6][7] .…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Findings of Post-wedge Bronchoplastic Lobectomy

Kitami

Sano

Ohashi

et al. 2015

Showa Univ J Med Sci

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: It is speculated that the advantage of wedge bronchoplastic lobectomy lies in the reduction in the incidence of major anastomotic complications. On the other hand, wedge bronchoscopic lobectomy can result in kinking at the anastomosis site. This study was performed to evaluate the operative outcomes and the postoperative endoscopic ndings for wedge resection of the bronchus. From 2004 to 2012, nine patients underwent wedge bronchoplastic lobectomy for lung carcinoma. We evaluated the angles of the wedge and the distance of the preserved parts to the cut line of the bronchus the so-called bronchial bridge . There were six right upper lobectomies, two middle and lower lobectomies, and one left lower lobectomy. Regarding bronchoscopic ndings, ve patients who underwent right upper lobectomy showed bulging into the bronchial lumen. There were no anastomotic strictures. Intraoperatively it was noted in these ve patients that the bronchial bridge tended to be relatively long and / or the angle of the wedge resection tended to be relatively wide. To prevent bulging into the bronchial lumen after right upper wedge bronchoplastic lobectomy, bronchial wedge excisions should be shaped in order to reduce the length of the bronchial bridge.

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“…Anastomotic site is covered with pericardial fat, parietal pleura, internal intercostal muscle or fibrin glue to prevent leak and fistula [11]. Sleeve lobectomy has been reported to have higher rates of anastomotic complications, similar tumor and nodal clearance and similar local recurrence [5-24 %] and operation mortality [2.7-7.5 %] when compared to wedge bronchoplasty [12][13][14]. Postoperative sputum retention has been reported to be as high as 14.7 % after wedge bronchoplasty and often requires bronchoscopic toileting [14].…”

Section: Discussionmentioning

confidence: 99%

Bronchoscopic Debulking Followed by Bronchoplastic Procedure Helps in Limiting Lung Resection in a Bronchial Carcinoid: A Case Report

Pandey

Ramanathan

Khurse

et al. 2014

Indian J Surg Oncol

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Bronchoplasty is a conservative procedure in lung surgeries used in the past for patients with poor functional status but recently these procedures have been performed in low grade malignant tumors of lung avoiding extensive morbid procedure like pneumonectomy without compromising the oncologic outcome. We describe a case of bronchial carcinoid treated by bronchoscopic intervention followed by wedge bronchoplasty. The importance of bronchoscopic debulking of the tumor for accurate assessment of its extent has been highlighted. A parenchyma preserving pulmonary resection can then be performed with bronchoplastic technique, thus avoiding pneumonectomy.

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Postoperative complications after bronchoplastic procedures in the treatment of bronchial malignancies1

Cited by 34 publications

References 10 publications

History and current status of bronchoplastic surgery for lung cancer

History and current status of bronchoplastic surgery for lung cancer

Endoscopic Findings of Post-wedge Bronchoplastic Lobectomy

Bronchoscopic Debulking Followed by Bronchoplastic Procedure Helps in Limiting Lung Resection in a Bronchial Carcinoid: A Case Report

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