Short-term outcome of bronchial sleeve lobectomy

Abstract

Objective: Bronchial sleeve lobectomy is a technically demanding procedure that has gradually gained acceptance as a standard resection technique for lung cancer. We present the early results of sleeve lobectomy in 32 consecutive patients operated on during the time frame.Patients and Methods: This is a prospective study that included 32 patients undergoing sleeve lobectomy during the period from November 2006 to December 2008. Data of preoperative work up, operative procedures, perioperative mortality and morbidity were collected. Patients were followed up and any anastomotic complications, tumor recurrence or mortality were also recorded.Results: Procedures included 32 sleeve lobectomies; in 8 patients sleeve arterectomy was also performed. Resection was complete in 31 (96.9%) patients. Histopatholoic examination revealed that there were 20 (62.5%) Non Small Cell Lung Cancer (NSCLC) and 8 (25%) carcinoid tumors. There was only one (3.125%) perioperative death, median length of hospital stay was 9 days. perioperative complication rate was 21.87%. These complications were atrial arrhythmia, retention of secretions, prolonged air leak and chylothorax. There were no bronchopleural or bronchovascular complications. The mean follow-up duration was 16.8 months; there was no local recurrence. Only 1 patient developed moderate anastomotic stenosis and underwent successful bronchoscopic dilatation.Conclusions: Sleeve lobectomy with or without pulmonary artery angioplasty can be performed with acceptable mortality and morbidity rates. These procedures should be performed as an alternative to pneumonectomy -regardless the pulmonary functional state-provided that complete tumor resection can be achieved. (Ind J Thorac Cardiovasc Surg 2009; 25: 63-67)