The Incidence of Perioperative Anastomotic Complications After Sleeve Lobectomy Is Not Increased After Neoadjuvant Chemoradiotherapy

Milman, Steven; Kim, Anthony W.; Warren, William H.; Liptay, Michael J.; Miller, Catherine L.; Basu, Sanjib; Faber, L. Penfield

doi:10.1016/j.athoracsur.2009.05.084

Cited by 38 publications

(28 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…23,[26][27][28][29][30] Although we along with other authors 23,[26][27][28]30 have proved in the past years the possibility of performing even complex broncho-vascular reconstructive procedures after induction therapy with short-term and long-term results comparable with those of the standard procedures, special concern has been expressed by many thoracic surgeons when considering such operations because of the theoretically higher risk of perioperative complications and mortality. Only few experiences have been published so far reporting the routine use of sleeve resection after neoadjuvant therapy.…”

Section: Discussionmentioning

confidence: 96%

Sleeve Lobectomy Compared with Pneumonectomy after Induction Therapy for Non–Small-Cell Lung Cancer

Maurizi

D’Andrilli

Anile

et al. 2013

Journal of Thoracic Oncology

View full text Add to dashboard Cite

Background:We compared morbidity, mortality, and oncological results of bronchial and/or vascular sleeve lobectomy (SL) with those of pneumonectomy (PN) after induction therapy for lung cancer. Methods: Between 1998 and 2011, 82 patients receiving induction therapy (chemo or chemo-radiotherapy) for non-small-cell-lungcancer underwent sleeve lobectomy (n = 39) or pneumonectomy (n = 43). Only patients undergoing preoperative chemotherapy (39 in the SL group and 39 in the PN group) were included in the study. SL was bronchial in 21, vascular in 12, and broncho-vascular in six cases, respectively. Clinical stage before induction therapy was IIb in seven patients (1 in PN group; 6 in SL group), IIIa in 66 (36 in PN group; 30 in SL group), and IIIb in five patients (2 in PN group; 3 in SL group), respectively. N3 patients were not included in this series. Results: The rate of downstaged patients (pathological complete response and stage I-II) was 79.5% in the SL group and 53.8% in the PN group (p = 0.01).Postpneumonectomy mortality rate was 2.6 %. There was no postoperative mortality after SL. Complications occurred in 12 patients (30.8%) after PN and in 11 patients (28.2%) after SL (p = 0.6). Three-year and 5-year survival rates were 68 ± 3% and 64 ± 8% in the SL group; and 59.5 ± 5% and 34.5 ± 8% in the PN group (p = 0.02). The difference in terms of recurrence rate (locoregional and distant) between the two groups was not significant (p = 0.2). Conclusions: SL represents a valid therapeutic option even after induction chemotherapy, providing better long-term survival than PN, with no increase of postoperative complications or recurrence rate. Pathological downstaging is a favorable prognostic factor. Between 1998 and 2011, 82 patients with NSCLC underwent bronchial and/or vascular SL (39 patients; 47.6%) or PN (43 patients; 52.4%) after induction chemotherapy or chemo-radiotherapy. Only patients undergoing preoperative chemotherapy (39 in the SL group and 39 in the PN group) were included in the study. The four patients receiving induction chemo-radiotherapy in the PN group were excluded because the preoperative irradiation could represent a factor influencing results. Patients undergoing previous surgical exploration were not included. We also excluded N3 cases. PATIENTS AND METHODS

show abstract

Section: Discussionmentioning

confidence: 96%

Sleeve Lobectomy Compared with Pneumonectomy after Induction Therapy for Non–Small-Cell Lung Cancer

Maurizi

D’Andrilli

Anile

et al. 2013

Journal of Thoracic Oncology

View full text Add to dashboard Cite

show abstract

“…This may mean that wound healing of the anastomosis is compromised by neoadjuvant radiotherapy and may require more attention to avoid late complications. [9][10][11][12][13][14] We therefore introduced the routine procedure of covering the bronchial anastomosis with vital tissue such as pedicled thymus flaps, muscle flap, or pericardial flaps in patients after neoadjuvant treatment including radiotherapy to protect the anastomosis. 15,16 Thirty-day mortality in these patients was not increased compared with the overall 30-day mortality (1%).…”

Section: Discussionmentioning

confidence: 99%

A new classification of bronchial anastomosis after sleeve lobectomy

Ludwig

Stoelben

2012

The Journal of Thoracic and Cardiovascular Surgery

View full text Add to dashboard Cite

“…21 There are few data regarding the use of sleeve lobectomy after neoadjuvant therapy. According to 3 studies that examined the safety of sleeve lobectomy after induction therapy, [69][70][71] performing sleeve resection after induction therapy does not result in an increase in the rates of mortality or anastomotic complications, such as bronchial fistulas. According to the retrospective results obtained at our institution, pneumonectomy (12 of 39) and sleeve lobectomy (6 of 39) after neoadjuvant chemoradiotherapy can safely be performed without mortality or comorbidities.…”

Section: Objective Risks Of Surgical Resection After Induction Therapymentioning

confidence: 99%

Multimodality Treatment With Surgery for Locally Advanced Non–Small-Cell Lung Cancer With N2 Disease: A Review Article

Toyokawa¹,

Takenoyama²,

Ichinose³

2015

Clinical Lung Cancer

View full text Add to dashboard Cite

The Incidence of Perioperative Anastomotic Complications After Sleeve Lobectomy Is Not Increased After Neoadjuvant Chemoradiotherapy

Cited by 38 publications

References 15 publications

Sleeve Lobectomy Compared with Pneumonectomy after Induction Therapy for Non–Small-Cell Lung Cancer

Sleeve Lobectomy Compared with Pneumonectomy after Induction Therapy for Non–Small-Cell Lung Cancer

A new classification of bronchial anastomosis after sleeve lobectomy

Multimodality Treatment With Surgery for Locally Advanced Non–Small-Cell Lung Cancer With N2 Disease: A Review Article

Contact Info

Product

Resources

About