Bronchial sleeve resection after downstaging in advanced NSCLC

• Published in: The Thoracic and Cardiovascular Surgeon
• Main Authors: Graeter, T, Lausberg, H, Tscholl, D, Hellwig, D, Hessami, M, Schäfers, H
• Format: Conference Proceeding
• Language: English; German
• Published: 18.01.2005
• ISSN: 0171-6425; 1439-1902
• DOI: 10.1055/s-2005-862177

Objectives: Neoadjuvant therapy is a promising alternative in patients with locally advanced bronchogenic carcinoma. This may be associated with an increased risk of morbidity and mortality especially after bronchial sleeve resection. We compared our results after induction therapy of patients with typical lung resection and bronchial sleeve resection. Material and Methods: Between July 1998 and February 2004 we operated on 51 patients following induction therapy. Seventeen underwent bronchial or bronchovascular sleeve resection (group 1) and 34 had typical pulmonary resections (group 2). All patients received chemotherapy, 14 patients in group 1 and 24 patients in group 2 had additional radiation treatment. In group 1 two patients were in stage IIIa and 15 in IIIb, in group 2 four were in stage IIIa and 30 in IIIb Mean age was 59±8 years in group 1 and 58±7 years in group 2. Results: There were no bronchial complications related to the bronchial anastomosis. In group 1 one patient died due to pneumonia on postoperative day 40, whereas there were no early deaths in group 2. Hospital mortality was 5.9% in group 1 and 0% in group 2. Following 3 years actuarial survival was 60±11% in group 1 and 53±11% in group 2. Conclusions: We conclude that in patients following induction therapy bronchial sleeve resection can be performed with acceptable morbidity and mortality. It is not associated with an increased risk of anastomotic complications and represents a valid therapeutic option for selected patients.