Tracheal sleeve pneumonectomy: Long-term outcome

Roviaro, Giancarlo; Vergani, Contardo; Maciocco, M.; Varoli, F.; Francese, M.; Despini, Luca

doi:10.1016/j.lungcan.2005.12.001

Cited by 38 publications

(31 citation statements)

References 24 publications

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“…The operative mortalities of the studies in the last decade are between 4% and 16% and are generally related to pulmonary complications (Table 2). [6,[10][11][12][13][14][15][16][17] Those results are close to the 6% (range 5-15%) mortality of classical pneumonectomy. [16,17] Dartevelle et al [4] reported a 40% five-year survival in a series of 55 patients.…”

Section: Discussionsupporting

confidence: 75%

Tracheal sleeve pneumonectomy: an analysis of 13 cases

Gezer¹,

Öz²,

Ege³

et al. 2011

Turkish J Thorac Cardiovasc Surg

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Amaç: Bu çalışmada trakeal sleeve pnömonektomi (TSP) uyguladığımız olgulara ait sonuçlar incelendi. Ça lış ma pla nı: Ocak 2000 ile Temmuz 2009 tarihleri arasında küçük hücreli dışı akciğer kanseri nedeni ile 13 erkek hastaya (ort. yaş 52; dağılım 40-65 yıl) kliniğimizde TSP uygulandı. Hastalar yaş, cinsiyet, histopatolojik muayeneleri ve evreleri ile adjuvan tedaviler, ameliyat sonrası komplikasyonlar ve sağkalım açısından geriye dönük olarak incelendi. Hastaların ortalama ve beş yıllık sağkalım-ları Kaplan-Meier yöntemi ile hesaplandı. Bul gu lar: On üç hastanın 11'ine sağ, ikisine sol TSP uygulandı. Histopatolojik tanı, 11 hastada skuamöz hüc-reli karsinom, bir hastada adenokarsinom ve bir hastada adeno-skuamöz karsinom idi. Tümör, lenf nodu metastazı evrelemeleri bir hastada evre IIB, bir hastada evre IIIA ve 11 hastada evre IIIB idi. Dört hastada ameliyat sonrası komplikasyon görüldü ve bunların ikisi anastomoz ile ilişkili idi. Biri ameliyat sonrası dönemde olmak üzere takip süresince toplam üç hasta kaybedildi. Ortalam sağ-kalım süresi ve beş yıllık sağkalım oranları sırasıyla 87 ay ve %77 idi. So nuç: Trakeal sleeve pnömonektomi karinaya invaze veya yakın komşu olan akciğer kanseri tedavisinde önemli bir yöntemdir. Göğüs cerrahisindeki gelişmelerle morbidite ve mortalitesi azalmış olup bugün için standart pnömo-nektomininkine yakındır. Mediastinal lenf nodu tutulumu bir kontrendikasyon olmalıdır. Bunun tek istisnası, en blok rezeksiyonun mümkün olduğu subkarinal lenf nodu tutulumudur.Anah tar söz cük ler: Karina rezeksiyonu; küçük hücreli dışı akciğer kanseri; trakeal sleeve pnömonektomi; trakeobronşiyal anastomoz.Background:In this study, we evaluated the results of our tracheal sleeve pneumonectomy (TSP) cases. Methods: Thirteen male patients (mean age 52; range 40 to 65 years) with non-small cell lung cancer underwent TSP in our clinic between January 2000 and July 2009. The patients were evaluated for age, sex, histopathological examinations and stages, adjuvant therapies, postoperative complications and survival retrospectively. The mean and five-year survivals of patients were analyzed with KaplanMeier method. Results: Eleven right and two left TSPs were performed in 13 patients. The histopathological diagnoses were squamous cell carcinoma in 11 patients, adenocarcinoma in one patient and adeno-squamous carcinoma in one patient. The tumor-node-metastasis staging was stage IIB in one patient, stage IIIA in one patient and stage IIIB in 11 patients. Four patients had complications after the surgery, and two of these were anastomosis-related. A total of three patients died during follow-up, one of them in the postoperative period. The mean survival and the five-year survival rate were 87 months and 77%, respectively. Conclusion:Tracheal sleeve pneumonectomy is an important modality in the treatment of lung cancer that has invaded or is in close proximity with the carina. With improvements in the thoracic surgery, the morbidity and mortality of TSP have improved and are currently close to the standard ...

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Section: Discussionsupporting

confidence: 75%

Tracheal sleeve pneumonectomy: an analysis of 13 cases

Gezer¹,

Öz²,

Ege³

et al. 2011

Turkish J Thorac Cardiovasc Surg

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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: 77%

“…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%

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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“…Although technical complexity of these procedures remains high and only few centres worldwide have obtained a wide range of experience, in the last decade the operative mortality has been reported under 10% with 5-year survival rates ranging between 33% and 44% (table 4) [56,[58][59][60][61][62][63][64].…”

Section: Carinal Resectionsmentioning

confidence: 99%

Tracheal surgery

D’Andrilli

Rendina

Venuta

2016

Monaldi Arch Chest Dis

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Surgical resection and reconstruction of the trachea can be performed both for benign and malignant diseases. The main indications for surgery include inflammatory (generally post-intubation), congenital or post-traumatic stenoses, degenerative lesions, benign or malignant neoplasms. Success can be pursued only by accurate patient selection and timing, meticulous surgical techniques, careful follow up and, when required, multidisciplinary cooperation. Although surgical resection has now become part of our surgical practice, other treatment modalities are approaching a new clinical application era, in particular tracheal transplantation and bioengineering. These new techniques will certainly offer, in the near future, improved chances to treat difficult cases.

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Tracheal sleeve pneumonectomy: Long-term outcome

Cited by 38 publications

References 24 publications

Tracheal sleeve pneumonectomy: an analysis of 13 cases

Tracheal sleeve pneumonectomy: an analysis of 13 cases

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

Tracheal surgery

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