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Postoperative complications after bronchoplastic procedures in the treatment of bronchial malignancies
Objective: The purpose of this study was to determine the frequency of postoperative complications after bronchoplastic procedures in the treatment of pulmonary malignant tumors and to analyze the factors influencing the complication rate. Methods: During a 5-year-period (1992–1996) 79 patients (68...
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| Published in: | European journal of cardio-thoracic surgery 1998-07, Vol.14 (1), p.46-53 |
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| container_title | European journal of cardio-thoracic surgery |
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| creator | Krüger, Marcus Uschinsky, Klaus Häßler, Kathrin Engelmann, Claus |
| description | Objective: The purpose of this study was to determine the frequency of postoperative complications after bronchoplastic procedures in the treatment of pulmonary malignant tumors and to analyze the factors influencing the complication rate. Methods: During a 5-year-period (1992–1996) 79 patients (68 male, 11 female, mean age 57 years) underwent reconstructive operations for bronchial malignancies. We performed 58 bronchoplastic procedures and 21 combined broncho- and angioplastic procedures. Among the bronchoplastic procedures the number of sleeve resections (n=44) and wedge resections (n=35) were comparable. Results: Fifty-nine patients (74,7%) showed a regular postoperative course; 12 patients (15,2%) had severe postoperative complications (death, re-operation). Concerning the primary operation the operative 30-day mortality was 5.1% (n=4) and including the two deaths after re-operation it was 7.6% (n=6). After subdividing the patients into three groups (severe, less severe and no complications) we tried to determine predictors for occurrence of postoperative complications. There was a higher rate of severe complications in the age group 61–70 years (6/25=24%) as compared with younger patients between 51 and 60 years (4/38=10,5%; P |
| doi_str_mv | 10.1016/S1010-7940(98)00143-2 |
| format | article |
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Methods: During a 5-year-period (1992–1996) 79 patients (68 male, 11 female, mean age 57 years) underwent reconstructive operations for bronchial malignancies. We performed 58 bronchoplastic procedures and 21 combined broncho- and angioplastic procedures. Among the bronchoplastic procedures the number of sleeve resections (n=44) and wedge resections (n=35) were comparable. Results: Fifty-nine patients (74,7%) showed a regular postoperative course; 12 patients (15,2%) had severe postoperative complications (death, re-operation). Concerning the primary operation the operative 30-day mortality was 5.1% (n=4) and including the two deaths after re-operation it was 7.6% (n=6). After subdividing the patients into three groups (severe, less severe and no complications) we tried to determine predictors for occurrence of postoperative complications. There was a higher rate of severe complications in the age group 61–70 years (6/25=24%) as compared with younger patients between 51 and 60 years (4/38=10,5%; P<0,05). Concerning the location, the outcome was better after sleeve- or wedge lobectomies of the upper lobes (four complications/51 patients=7.8%) compared with procedures of the lower lobes (3/14=21.4%). The data could not prove a lower frequency of severe postoperative complications or specific morbidity after pleural coverage following bronchial sleeve resection. The complication rate was higher when sleeve resection of the bronchus was performed (10/44=22.7%) as compared with wedge resections (2/35=5.7%; P=0,011) and after resection of T3/T4 tumors (6/28=21,4%) compared with T1/T2 tumors (4/37=10.8%; P<0,05). Conclusions: Bronchoplastic procedures represent a fairly safe therapy opportunity in patients with centrally localized bronchial carcinoma and compromised or uncompromized pulmonary function. In this study the complication rate was higher after sleeve resection of the bronchus as compared with wedge resection. Pleural coverage of the anastomosis was not effective to prevent major complications due to dehiscence of the bronchial anastomosis. A pedicled muscle flap could be a valuable alternative.</description><identifier>ISSN: 1010-7940</identifier><identifier>EISSN: 1873-734X</identifier><identifier>DOI: 10.1016/S1010-7940(98)00143-2</identifier><identifier>PMID: 9726614</identifier><identifier>CODEN: EJCSE7</identifier><language>eng</language><publisher>Amsterdam: Elsevier Science B.V</publisher><subject>Anastomotic coverage ; Biological and medical sciences ; Bronchi - surgery ; Bronchial Neoplasms - surgery ; Bronchoplastic resections ; Bronchoplasty ; Carcinoma, Squamous Cell - surgery ; Complications ; Female ; Humans ; Male ; Medical sciences ; Middle Aged ; NSCLC ; Postoperative Complications ; Sleeve-lobectomy ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the respiratory system ; Treatment Outcome</subject><ispartof>European journal of cardio-thoracic surgery, 1998-07, Vol.14 (1), p.46-53</ispartof><rights>1998 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2337367$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9726614$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Krüger, Marcus</creatorcontrib><creatorcontrib>Uschinsky, Klaus</creatorcontrib><creatorcontrib>Häßler, Kathrin</creatorcontrib><creatorcontrib>Engelmann, Claus</creatorcontrib><title>Postoperative complications after bronchoplastic procedures in the treatment of bronchial malignancies</title><title>European journal of cardio-thoracic surgery</title><addtitle>Eur J Cardiothorac Surg</addtitle><description>Objective: The purpose of this study was to determine the frequency of postoperative complications after bronchoplastic procedures in the treatment of pulmonary malignant tumors and to analyze the factors influencing the complication rate. Methods: During a 5-year-period (1992–1996) 79 patients (68 male, 11 female, mean age 57 years) underwent reconstructive operations for bronchial malignancies. We performed 58 bronchoplastic procedures and 21 combined broncho- and angioplastic procedures. Among the bronchoplastic procedures the number of sleeve resections (n=44) and wedge resections (n=35) were comparable. Results: Fifty-nine patients (74,7%) showed a regular postoperative course; 12 patients (15,2%) had severe postoperative complications (death, re-operation). Concerning the primary operation the operative 30-day mortality was 5.1% (n=4) and including the two deaths after re-operation it was 7.6% (n=6). After subdividing the patients into three groups (severe, less severe and no complications) we tried to determine predictors for occurrence of postoperative complications. There was a higher rate of severe complications in the age group 61–70 years (6/25=24%) as compared with younger patients between 51 and 60 years (4/38=10,5%; P<0,05). Concerning the location, the outcome was better after sleeve- or wedge lobectomies of the upper lobes (four complications/51 patients=7.8%) compared with procedures of the lower lobes (3/14=21.4%). The data could not prove a lower frequency of severe postoperative complications or specific morbidity after pleural coverage following bronchial sleeve resection. The complication rate was higher when sleeve resection of the bronchus was performed (10/44=22.7%) as compared with wedge resections (2/35=5.7%; P=0,011) and after resection of T3/T4 tumors (6/28=21,4%) compared with T1/T2 tumors (4/37=10.8%; P<0,05). Conclusions: Bronchoplastic procedures represent a fairly safe therapy opportunity in patients with centrally localized bronchial carcinoma and compromised or uncompromized pulmonary function. In this study the complication rate was higher after sleeve resection of the bronchus as compared with wedge resection. Pleural coverage of the anastomosis was not effective to prevent major complications due to dehiscence of the bronchial anastomosis. A pedicled muscle flap could be a valuable alternative.</description><subject>Anastomotic coverage</subject><subject>Biological and medical sciences</subject><subject>Bronchi - surgery</subject><subject>Bronchial Neoplasms - surgery</subject><subject>Bronchoplastic resections</subject><subject>Bronchoplasty</subject><subject>Carcinoma, Squamous Cell - surgery</subject><subject>Complications</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>NSCLC</subject><subject>Postoperative Complications</subject><subject>Sleeve-lobectomy</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the respiratory system</subject><subject>Treatment Outcome</subject><issn>1010-7940</issn><issn>1873-734X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1998</creationdate><recordtype>article</recordtype><recordid>eNo9kNtK5jAQgIOsuJ4eQciFLHpRzaHN4XLxjKKCCuJNSdPJ_nHbpib5Rd_eitWbOfB9DDOD0A4lB5RQcXg3RVJIXZI9rfYJoSUv2Apap0ryQvLy8ddUfyu_0UZKz4QQwZlcQ2taMiFouY7cbUg5jBBN9q-AbejHztupCUPCxmWIuIlhsIswdiZlb_EYg4V2GSFhP-C8AJwjmNzDkHFws-1Nh3vT-X-DGayHtIVWnekSbM95Ez2cntwfnRdXN2cXR3-vigUnMhda6ApaI6EVjjlaSlbKhpAWSEWhKqVyLeONBqEV2KYFx1RDlKONA11KQvkm-vM1d9ryZQkp171PFrrODBCWqZZcKaaqT3FnFpdND209Rt-b-F7Pj5n47sxNsqZz8fOO9KMxziUXctKKL82nDG8_2MT_9URlVZ8_PtXi8pof357e1Zp_APwFhNA</recordid><startdate>19980701</startdate><enddate>19980701</enddate><creator>Krüger, Marcus</creator><creator>Uschinsky, Klaus</creator><creator>Häßler, Kathrin</creator><creator>Engelmann, Claus</creator><general>Elsevier Science B.V</general><general>Elsevier Science</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>19980701</creationdate><title>Postoperative complications after bronchoplastic procedures in the treatment of bronchial malignancies</title><author>Krüger, Marcus ; Uschinsky, Klaus ; Häßler, Kathrin ; Engelmann, Claus</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-h307t-9695eda7ed6f2f147247b00de051e5478fd23b9e698ecbdef28b08f1bfe947013</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1998</creationdate><topic>Anastomotic coverage</topic><topic>Biological and medical sciences</topic><topic>Bronchi - surgery</topic><topic>Bronchial Neoplasms - surgery</topic><topic>Bronchoplastic resections</topic><topic>Bronchoplasty</topic><topic>Carcinoma, Squamous Cell - surgery</topic><topic>Complications</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>NSCLC</topic><topic>Postoperative Complications</topic><topic>Sleeve-lobectomy</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the respiratory system</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Krüger, Marcus</creatorcontrib><creatorcontrib>Uschinsky, Klaus</creatorcontrib><creatorcontrib>Häßler, Kathrin</creatorcontrib><creatorcontrib>Engelmann, Claus</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of cardio-thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Krüger, Marcus</au><au>Uschinsky, Klaus</au><au>Häßler, Kathrin</au><au>Engelmann, Claus</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Postoperative complications after bronchoplastic procedures in the treatment of bronchial malignancies</atitle><jtitle>European journal of cardio-thoracic surgery</jtitle><addtitle>Eur J Cardiothorac Surg</addtitle><date>1998-07-01</date><risdate>1998</risdate><volume>14</volume><issue>1</issue><spage>46</spage><epage>53</epage><pages>46-53</pages><issn>1010-7940</issn><eissn>1873-734X</eissn><coden>EJCSE7</coden><abstract>Objective: The purpose of this study was to determine the frequency of postoperative complications after bronchoplastic procedures in the treatment of pulmonary malignant tumors and to analyze the factors influencing the complication rate. Methods: During a 5-year-period (1992–1996) 79 patients (68 male, 11 female, mean age 57 years) underwent reconstructive operations for bronchial malignancies. We performed 58 bronchoplastic procedures and 21 combined broncho- and angioplastic procedures. Among the bronchoplastic procedures the number of sleeve resections (n=44) and wedge resections (n=35) were comparable. Results: Fifty-nine patients (74,7%) showed a regular postoperative course; 12 patients (15,2%) had severe postoperative complications (death, re-operation). Concerning the primary operation the operative 30-day mortality was 5.1% (n=4) and including the two deaths after re-operation it was 7.6% (n=6). After subdividing the patients into three groups (severe, less severe and no complications) we tried to determine predictors for occurrence of postoperative complications. There was a higher rate of severe complications in the age group 61–70 years (6/25=24%) as compared with younger patients between 51 and 60 years (4/38=10,5%; P<0,05). Concerning the location, the outcome was better after sleeve- or wedge lobectomies of the upper lobes (four complications/51 patients=7.8%) compared with procedures of the lower lobes (3/14=21.4%). The data could not prove a lower frequency of severe postoperative complications or specific morbidity after pleural coverage following bronchial sleeve resection. The complication rate was higher when sleeve resection of the bronchus was performed (10/44=22.7%) as compared with wedge resections (2/35=5.7%; P=0,011) and after resection of T3/T4 tumors (6/28=21,4%) compared with T1/T2 tumors (4/37=10.8%; P<0,05). Conclusions: Bronchoplastic procedures represent a fairly safe therapy opportunity in patients with centrally localized bronchial carcinoma and compromised or uncompromized pulmonary function. In this study the complication rate was higher after sleeve resection of the bronchus as compared with wedge resection. Pleural coverage of the anastomosis was not effective to prevent major complications due to dehiscence of the bronchial anastomosis. A pedicled muscle flap could be a valuable alternative.</abstract><cop>Amsterdam</cop><pub>Elsevier Science B.V</pub><pmid>9726614</pmid><doi>10.1016/S1010-7940(98)00143-2</doi><tpages>8</tpages></addata></record> |
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| ispartof | European journal of cardio-thoracic surgery, 1998-07, Vol.14 (1), p.46-53 |
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| source | Oxford Journals Online |
| subjects | Anastomotic coverage Biological and medical sciences Bronchi - surgery Bronchial Neoplasms - surgery Bronchoplastic resections Bronchoplasty Carcinoma, Squamous Cell - surgery Complications Female Humans Male Medical sciences Middle Aged NSCLC Postoperative Complications Sleeve-lobectomy Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the respiratory system Treatment Outcome |
| title | Postoperative complications after bronchoplastic procedures in the treatment of bronchial malignancies |
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