Multisegmental lobe bronchoplasty for the treatment of non-small-cell lung cancer

Abstract

Bronchoplasty was extended to the segmental level and the effect of the multi-segmental surgery for the central non-small lung cancer was observed. The involved lobular bronchi and part of main bronchi were resected and single-layer continuous suture with 5-0 Prolene was used for suturing of the carina of the reconstructed segmental bronchi to form lobular bronchi. Then, single-layer continuous suture with 4-0 Prolene was employed to anastomose the “lobular bronchi” with main bronchi. Our results showed that the 15 bronchoplasties were successfully performed. The tumors were completely removed and postoperatively, the pulmonary functions of the patients were substantially improved. No broncho-pleural fistula and stomal stenosis took place in all the cases. The quality of life of the patients were obviously improved. It is concluded that multisegmental bronchoplasty can completely remove the tumor of central non-small-cell lung cancer and conserve more non-involved lung. The procedure is especially suitable for those patients with severely impaired lung functions and it expands the indications of surgical resection of lung cancer.

Keywords

bronchoplasty / non-small-cell lung cancer / surgical treatment / indications

References

[1] OkadaM., TsubataN., YoshimuraM., et al.. Extended sleeve lobectomy for lung cancer: The avoidance of pneumonectomy. J Thorac Cardiovasc Surg, 1999, 118: 710-714

[2] FaberL. P.. Sleeve lobectomy. Chest Surg Clin North Am, 1995, 5: 233-251

[3] MountainC. F.. Revisions in the international system for staging lung cancer. Chest, 1997, 111: 1710-1717

[4] DeneffeG., LacquetL. M., VerbekenE., et al.. Surgical treatment of bronchogenic carcinoma: A retrospective study of 720 thoracotomies. Ann Thorac Surg, 1988, 45: 380-383

[5] TsurbotaN., YoshimuraM., MurotaniA., et al.. One hundred and one cases of bronchoplasty for primary lung cancer. Sury Today, 1994, 24: 978-981

[6] TedderM., AnstadtM., TedderS. D., et al.. Current morbidity, mortality,and survival after bronchoplastic procedures for malignancy. Ann Thorac Surg, 1992, 54: 387-391

[7] PaulsonD. L., UrschelH. C.Jr, McNamaraJ. J., et al.. Bronchoplastic procedures for bronchogenic carcinoma. J Thorac Cardiovasc Surg, 1970, 59: 38-48