Background. Tracheo-bronchial and vascular sleeve procedures represent an effective surgical therapy for benign lesions, tumours of low-grade malignancy and bronchogenic carcinoma in selected patients. Methods. From January 1980 to August 2002, 248 patients underwent sleeve procedures. We performed 195 bronchial sleeves and 53 tracheo-bronchial sleeves: 39 cases of sleeve lobectomy (SL) had vascular plasty associated, five of whom were arterial sleeve resection. Histological examination revealed 178 squamous carcinomas, 24 adenocarcinomas, 5 small cells carcinomas, 5 large cell carcinomas, 1 adenosquamous carcinomas, 25 bronchial carcinoids (19 typical and 6 atypical), 4 mucoepidermoid tumours, 4 adenoid-cystic carcinoma, 1 metastatic tumours, 1 bronchial stenosis post lung transplantation. 123 patients had N0 disease, 75 had N1 disease and 50 patients had N2 disease. In bronchial carcinoid disease 5 patients had N+. 106 patients had preoperative and/or postoperative irradiation/CT; 14 patients with carcinoid tumours underwent preoperative LASER-therapy. In 125 patients we used a perianastomotic pedicled flap. Results. 48 patients (19.3%) had postoperative complications. The 30-day mortality was 6% (15 patients). Overall survival at 5 and 10 years for all patients with lung cancer was 42% and 31%, respectively. Low malignancy and carcinoid tumours had overall survival of 88% at 5 and 10 years. Conclusions. Bronchovascular procedures are a safe and effective therapy in selected patients with pulmonary neoplasia. Tracheo-bronchial sleeves are associated with high postoperative mortality and complication rates. A multivariate analysis showed that nodal status, age, preoperative RT and histology were the significant prognostic factors affecting the long-term survival (P<0,05).

Reconstructive tracheo-bronchial surgery: bronchial, tracheal and vascular sleeve resections

SARTORI, FRANCESCO;ZUIN, ANDREA;REA, FEDERICO
2002

Abstract

Background. Tracheo-bronchial and vascular sleeve procedures represent an effective surgical therapy for benign lesions, tumours of low-grade malignancy and bronchogenic carcinoma in selected patients. Methods. From January 1980 to August 2002, 248 patients underwent sleeve procedures. We performed 195 bronchial sleeves and 53 tracheo-bronchial sleeves: 39 cases of sleeve lobectomy (SL) had vascular plasty associated, five of whom were arterial sleeve resection. Histological examination revealed 178 squamous carcinomas, 24 adenocarcinomas, 5 small cells carcinomas, 5 large cell carcinomas, 1 adenosquamous carcinomas, 25 bronchial carcinoids (19 typical and 6 atypical), 4 mucoepidermoid tumours, 4 adenoid-cystic carcinoma, 1 metastatic tumours, 1 bronchial stenosis post lung transplantation. 123 patients had N0 disease, 75 had N1 disease and 50 patients had N2 disease. In bronchial carcinoid disease 5 patients had N+. 106 patients had preoperative and/or postoperative irradiation/CT; 14 patients with carcinoid tumours underwent preoperative LASER-therapy. In 125 patients we used a perianastomotic pedicled flap. Results. 48 patients (19.3%) had postoperative complications. The 30-day mortality was 6% (15 patients). Overall survival at 5 and 10 years for all patients with lung cancer was 42% and 31%, respectively. Low malignancy and carcinoid tumours had overall survival of 88% at 5 and 10 years. Conclusions. Bronchovascular procedures are a safe and effective therapy in selected patients with pulmonary neoplasia. Tracheo-bronchial sleeves are associated with high postoperative mortality and complication rates. A multivariate analysis showed that nodal status, age, preoperative RT and histology were the significant prognostic factors affecting the long-term survival (P<0,05).
2002
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11577/2430209
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