Short- and long-term outcome of sleeve resections in the elderly☆

Abstract

In the hands of experienced thoracic surgeons, bronchial and bronchovascular sleeve resections can be performed safely, even in elderly patients. Excessive dynamic airway collapse may be an important negative prognostic determinant of morbidity and mortality.

Determining the appropriate sleeve lobectomy versus pneumonectomy ratio in central non-small cell lung cancer patients: an audit of an aggressive policy of pneumonectomy avoidance

“…In our series, this type is also the most frequent, but with only about 50% of cases. The explanation may be found in the increased number of SL in other locations, particularly the left upper SL (LUSL), frequently with associated arterial reconstruction [10,12,18,19].…”

“…First, the number of PNs decreased greatly and the rate of major complications such as bronchial failure and acute respiratory distress syndrome (ARDS) become almost anecdotal. Second, these reconstructive techniques increased the number of respiratory impaired patients with central tumours who are eligible for surgery, increasing the general resectability rate in NSCLC patients [12]. Finally, surgical treatment of second primary tumours, often precluded for functional reasons, was more frequently salvaged as a treatment option [9].…”

“…Long-term results are at least similar in local recurrence and survival [4,10], although it has been reported that the preservation of lung parenchyma contributes to improved postoperative respiratory function and decreases the longterm loss of respiratory capacity [11,12].…”

Expiratory reactance abnormalities in patients with expiratory dynamic airway collapse: a new application of impulse oscillometry

“…Symptoms of EDAC may include cough, breathlessness and mucus retention [ 11 , 12 ]. EDAC has remained difficult to detect physiologically, and there is a particular need for a physiological way to monitor for effects of treatment such as continuous positive airway pressure (CPAP) and surgical stabilisation of the trachea [ 1 , 6 , 13 ].…”

Pneumonectomy vs. Sleeve Resection for Non-Small Cell Lung Carcinoma in the Elderly: Analysis of Short-term and Long-term Results

“…Avoiding pneumonectomy seems to be as-sociated with better outcomes in the elderly [3]. We have reported on short-and long-term outcomes of sleeve resection in the elderly and demonstrated that bronchial and bronchovascular sleeve resections can be performed safely, even in elderly patients [4]. However there are few studies which specifically address a comparative analysis of outcomes after pneumonectomy and sleeve resection in elderly patients with NSCLC.…”