Tracheal sleeve pneumonectomy for non small cell lung cancer (NSCLC): Short and long-term results in a single institution

Rea, Federico; Marulli, Giuseppe; Schiavon, Marco; Zuin, Andrea; Hamad, Abdel-Mohsen; Feltracco, Paolo; Sartori, F

doi:10.1016/j.lungcan.2007.12.015

Cited by 50 publications

(51 citation statements)

References 25 publications

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“…The postoperative mortality for sleeve pneumonectomy has been reported to range from 6.1% to 7.5%, and the overall 5-year survival rate ranges from 26.5% to 33.4%. [2][3][4] These results seem to be acceptable compared to those of standard pneumonectomy.…”

Section: Discussionmentioning

confidence: 74%

“…Many reports have recommended that patients with N2 disease resistant to preoperative chemotherapy and/or radiotherapy should be excluded from this procedure. [2][3][4][5] Moreover, left sleeve pneumonectomy is rarely indicated, since the left main bronchus is considerably longer than the right one, and, in the case of carinal involvement, the tumor usually involves the structures in the subaortic space as well, which automatically implies inoperability. 5 Rea et al 2 reported that just one left pneumonectomy was done among 49 patients who underwent carinal resection.…”

Section: Discussionmentioning

confidence: 99%

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Left sleeve pneumonectomy via a clamshell incision for lung cancer with carinal invasion: report of a case

et al. 2011

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Surgery for lung cancer involving the carina has been a challenge due to surgical technique and airway management. A case that was successfully treated with left sleeve pneumonectomy performed through a clamshell incision (bilateral thoracotomy through a transverse sternotomy) for carinal invasion of primary lung cancer, is reported.Without a cardiopulmonary assist device, adequate ventilation and oxygenation were maintained across the operative field with a spinal tube. Tracheo-bronchial anastomosis was relatively easy to perform with the excellent surgical view. The patients' postoperative course was uneventful, and chest CT showed no complications at the anastomosis. The patient was discharged without oxygen support. There has been no evidence of recurrence during 6 months of follow-up.A clamshell incision approach provided an excellent surgical view without changing the position of the patient during the operation and could be a useful procedure for carinal surgery, especially for left sleeve pneumonectomy.

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Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Left sleeve pneumonectomy via a clamshell incision for lung cancer with carinal invasion: report of a case

et al. 2011

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“…However moderate ventilation of the lung on the operative site may be observed which may affect optimal exposure, especially when using a minimally invasive approach. Additionally, there is a certain risk of barotrauma which in rare cases can result in an acute respiratory distress syndrome (ARDS) (3,18,19).…”

Section: Perioperative Ventilation During Surgery Of the Central Airwaysmentioning

confidence: 99%

Minimally invasive resection and reconstruction of the intrathoracic trachea and carina

Kocher

Dorn

2017

J. Thorac. Dis.

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“…Rarely, cardiopulmonary bypass is required [131]. Isolated tracheobronchial resections can be performed without lung resections, but in many cases a lobectomy or a pneumonectomy is necessary [130,[132][133][134]. Perioperative mortality remains high: 2.5% to 15% in most series.…”

Section: Carinal Resections and Sleeve Pneumonectomiesmentioning

confidence: 99%

“…Complications mostly include pneumonia, adult respiratory distress syndrome (following pneumonectoy) and anastomotic complications (leakage or stenosis) [130,[132][133][134]. Nodal status has a significant impact on survival, with 5-year survival rates up to 51% in patients with N0 disease and down to 0-12% in those with N2 disease [130,[132][133][134]. Therefore, surgery is recommended for patients with N0-N1 disease, as the benefit is worth the risk, but most surgeons now do not recommend carinal resection when N2 disease is proven preoperatively.…”

Section: Carinal Resections and Sleeve Pneumonectomiesmentioning

confidence: 99%

Surgery for nonsmall cell lung cancer

Lang-Lazdunski

2013

European Respiratory Review

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Surgery remains the best curative option in patients with early stage lung cancer (stage I and II). Developments in minimally invasive techniques now allow surgeons to perform lung resections on elderly patients, patients with poor pulmonary function or significant cardiopulmonary comorbidities. New techniques, such as stereotactic radiotherapy and ablative procedures, are being evaluated in early-stage lung cancer and may represent an alternative to surgery in patients unfit for lung resection. Perioperative mortality rates have dropped significantly at most institutions in the past two decades and complications are managed more efficiently. Progress in imaging and staging techniques have helped cut futile thoracotomy rates and offer patients the most adequate treatment options. Large randomised trials have helped clarify the role of neoadjuvant, induction and adjuvant chemotherapy, as well as radiotherapy. Surgery remains an essential step in the multimodality therapy of selected patients with advanced-stage lung cancer (stage III and IV). Interventional and endoscopic techniques have reduced the role of surgery in the diagnosis and staging of nonsmall cell lung cancer, but surgery remains an important tool in the palliation of advanced-stage lung cancer. Large national/international surgical databases have been developed and predictive risk-models for surgical mortality/morbidity published by learned surgical societies. Nonetheless, lung cancer overall survival rates remain deceptively low and it is hoped that early detection/screening, better understanding of tumour biology and development of biomarkers, and development of efficient targeted therapies will help improve the prognosis of lung cancer patients in the next decade. @ERSpublications Despite progress in surgical techniques, radiotherapy techniques and targeted therapy, lung cancer prognosis remains poor

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Tracheal sleeve pneumonectomy for non small cell lung cancer (NSCLC): Short and long-term results in a single institution

Cited by 50 publications

References 25 publications

Left sleeve pneumonectomy via a clamshell incision for lung cancer with carinal invasion: report of a case

Left sleeve pneumonectomy via a clamshell incision for lung cancer with carinal invasion: report of a case

Minimally invasive resection and reconstruction of the intrathoracic trachea and carina

Surgery for nonsmall cell lung cancer

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