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J Thorac Cardiovasc Surg 2003;125:96-100
© 2003 The American Association for Thoracic Surgery

General Thoracic Surgery (GTS)

Efficacy and safety of tracheobronchoplasty after induction therapy for locally advanced lung cancer

From the Department of General Thoracic Surgery, Osaka University, Graduate School of Medicine,^a and the Division of Surgery, Toneyama National Hospital,^b Osaka, Japan.

Received for publication Feb 12, 2002. Revisions requested March 11, 2002; revisions received April 3, 2002. Accepted for publication May 21, 2002. Address for reprints: Mitsunori Ohta, MD, Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, E1 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan (E-mail: ohta{at}surg1.med.osaka-u.ac.jp).

Objectives: Patients receiving induction therapy may have increased risk of morbidity and mortality after surgery. We retrospectively evaluated the influence of preoperative treatment in patients who underwent sleeve resection for lung cancer.
Methods: A series of 48 consecutive patients who underwent sleeve resection with a telescoping anastomosis was retrospectively analyzed. A sleeve lobectomy and pneumonectomy were performed in 41 and 7 patients, respectively. Twenty patients received preoperative induction therapy; of them, 16 received induction chemoradiotherapy and 4 received only chemotherapy. Twenty-eight patients underwent the procedure without adjuvant therapy.
Results: The telescopic procedure was performed by placing sutures around the proximal and distal portions of the bronchial cartilage without wrapping the anastomosis. Among the 20 patients who received induction therapy, pulmonary angioplasty was performed in 5 and chest wall resection was performed in 3. Seven of these 20 patients (35%) had postoperative complications. Among the 28 patients without preoperative adjuvant therapy, pulmonary angioplasty was performed in 3, diaphragmatic resection was performed in 1, and chest wall resection was performed in 1. Three of these 28 patients (11%) had postoperative complications. Complications relating to the anastomosis occurred in 1 patient (5.0%) who received induction therapy; however, no operative deaths occurred. Bronchoscopic examinations demonstrated that mucosal healing was prolonged in patients who underwent induction therapy.
Conclusion: Induction therapy did not significantly affect morbidity or mortality among patients who underwent sleeve resection.

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