Different types of bronchial reconstruction in surgical treatment of non-small cell lung cancer. Analysis of our series

Abstract

Restrospective analysis from a prospective database:January-2007 to September-2018, 1076 anatomical pulmonary resections were performed, of them 60(5.6%) were bronchial reconstruction for malignant disease. We analysed type of bronchial reconstruction, suture, postoperative complications, and follow-up.

Results: male/female=50/10(83.3%/16.7%), mean age=60.5(range:26-79).

• -Sleeve lobectomy:39(65% two of them with pulmonary artery reconstruction and one with superior vena cava reconstruction),

• -Wedge-sleeve lobectomy:11(18.3% one of them with arterial reconstruction)

• -Sleeve bilobectomy:4(6.7%)

• -Sleeve segmentectomy:3(5%)

• -Lung-sparing sleeve bronchial resection:2(3.3%)

• -Bronchial reconstruction with autologous pericardium:1(1.7%)

Right upper lobectomy: the most frequent 29(48.3%). Histology: adenocarcinoma=5 (.3%), squamous=40(66.7%) carcinoid=8(13.3%), others: 7(11.6%)

Mean hospital stay:8.9days (s.d. 6.5). Induction treatment:5(8.3%), adjuvant Ch=19(31.7%), Rt=3(5.0%), Ch+Rt=7(11.7%).

Non-absorbable suture=42(70.0%), absorbable=18(30.0%). Postoperative mortality:3(5.0%)

Postoperative morbidity:

• - none:16(26.7%)

• - related to anastomosis:7(11.6%, two dehiscences with conservative treatment, two dehiscences with reoperation, one with diffuse mucus plugs and reintervention, two stenoses with dilatation)

There were no statistically significant differences in anastomosis complications according to type of suture (p=0.14) or type of bronchial resection(p=0.47). Overal survival was lower in lymph nodes metastases(p=0.04) and squamous/adenocarcinoma vs other histology(p=0.03).

Conclusions: We did not observe differences in types of surgical bronchial reconstruction.