Aim. To study the oncological expediency of using vascular techniques in organ-saving treatment of lung cancer. Materials and methods. Over the period of 2009–2016, there were performed 92 lobectomies with resection and reconstruction of the pulmonary artery in patients with non-small carcinoma of the lung. Results. No intraoperative complications and lethal outcomes were fixed. The postoperative complications were registered in 23 cases (25.3 %). Lethality was 3.3 %. The overall one-year survival rate in patients with stage I–III lung cancer after organ-saving surgery was 96.7 %, three-year – 65.1 %, five-year – 36.6 %, median survival rate – 53.1 months. The recurrence-free survival rate in patients with stage I–III lung cancer was: one-year – 89.9 %, three-year – 65.3 %, five-year – 48.8 %. The median recurrence-free survival rate was 49.8 months. Conclusions.Angioplastic lobectomy provides an acceptable short and long-term result, which does not yield to the analogous indices for pulmonectomy. It confirms our opinion on the expediency of implementing this procedure regarding non-small carcinoma of the lung.
Aim. To assess the effect of pulmonary hypertension on respiratory function in lung cancer surgery. Methods. 92 patients diagnosed with non-small cell lung cancer, among them 69 men (75 %) and 23 women (25 %), were operated on with different variants of angioplastic lobectomy (APL), the average age was 57.8 ± 6.7 years. 91 patients underwent pulmonectomy (PE), among them 87 men (95.6 %) and 4 women (4.4 %), the average age was 59 ± 8.8 years. Results. One year after angioplastic lobectomy FEV1 decreased by 0.69 liters (27 %), vital capacity decreased by 1.17 liters (32.9 %), FVC (the difference between the volumes of lungs at the beginning and at the end of forced expiration) reduced by 0.64 liters (20.5 %). After removal of the lung, dynamics of the decrease of similar indicators was 1.02 (42 %); 1.53 (43.8 %); 1.24 (40.3 %) liter respectively. The presence of a negative relationship between PA/A (pulmonary artery/aorta) and FEV1 was revealed. Thus, in the group of angioplastic lobectomy without initial pulmonary hypertension (PA/A less than 1) it was found that r = -0.42 (p < 0.01), with pulmonary hypertension (PA/A 1 or more) r = -0.4 (p < 0.01). In the group of pulmonectomy without initial pulmonary hypertension, the correlation index was -0.38 (p < 0.01), with initial pulmonary hypertension r = -0.33 (p < 0.01). Conclusion. The analysis of the functional parameters of pulmonary system after the surgery revealed statistically significant advantage of organ-saving treatment, as well as negative correlation between pulmonary hypertension and respiratory function.
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