Sleeve Resections for Squamous Cell Carcinoma of the Lung

• Published in: Heart, lung & circulation lung & circulation, 2010-09, Vol.19 (9), p.549-554
• Main Authors: Gezer, Suat, MD, Öz, Gürhan, MD, Fındık, Göktürk, MD, Türüt, Hasan, MD, Altınok, Tamer, MD, Sırmalı, Mehmet, MD, Gülhan, Erkmen, MD, Ağaçkıran, Yetkin, MD, Kaya, Sadi, MD, Taştepe, İrfan, MD
• Format: Article
• Language: English
• Subjects: Adult; Aged; Anastomosis, Surgical - methods; Bronchi - surgery; Carcinoma, Squamous Cell - mortality; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - surgery; Cardiovascular; Humans; Kaplan-Meier Estimate; Lung Neoplasms - mortality; Lung Neoplasms - pathology; Lung Neoplasms - surgery; Male; Middle Aged; Neoplasm Recurrence, Local; Parenchyma sparing operation; Pneumonectomy - methods; Postoperative Complications - mortality; Pulmonary malignancy; Sleeve lobectomy; Sleeve resection of lung; Survival Analysis; Treatment Outcome
• ISSN: 1443-9506; 1444-2892
• DOI: 10.1016/j.hlc.2010.02.026

Background Sleeve resection is an advanced technique that was developed as an alternative to pneumonectomy. This study evaluated our cases of sleeve resection for squamous cell carcinoma of the lung and compared the outcomes with the literature reports. Methods In total, 26 bronchial, 5 bronchovascular, and 3 vascular sleeve lobectomies were performed between January 2000 and July 2005 in our clinic. Age, gender, operations, postoperative diagnosis and staging, and postoperative morbidity and mortality were evaluated. Results Sleeve resections were performed in 34 patients. All patients were male, with a mean age of 59.4 years. The operations consisted of 16 right upper, 14 left upper, and 1 left lower sleeve lobectomies and 3 superior sleeve bilobectomies. The most common postoperative pathological staging group was stage IIb (32.3%). Operative mortality was 5.9% ( n = 2). Postoperative morbidity was 20.5% ( n = 7), including 4 prolonged air leaks plus empyema, 1 prolonged air leak, 1 postoperative bleeding needing revision, and 1 severe bronchostenosis; of these, 6 had persistent atelectasis. The local tumour recurrence rate was 11.7% ( n = 4). The median survival time and 5-year survival were 36 months and 42%, respectively. Conclusions Sleeve resection proved to be good therapy for lung cancer and has a lower morbidity and mortality than standard pneumonectomies and results in better lung function and quality of life. The anastomosis-related complications are experience-related technical complications and training thoracic surgeons to perform SRs at experienced centres will reduce the morbidity associated with SRs.