Bronchovascular sleeve resection. Technique, perioperative management, prevention, and treatment of complications.
Between May 1989 and May 1992, we performed bronchial sleeve resections or complex reconstructions of the pulmonary artery in 55 patients. Forty-four patients had bronchogenic carcinoma, and 11 had benign lesions. One patient died (mortality 1.8%) and three (5%) had minor complications (dehiscence or granuloma), which were treated by laser recanalization and recovered within 1 year. Ten patients underwent sleeve resection of the pulmonary artery or reconstruction of the vessel with a pericardial patch with no complications. In patients with lung cancer, 2-year survival was 72%, whereas all patients with benign lesions were alive and well at 8 months to 3 years after the operation. We consider accurate surgical technique, bronchial protection with a pedicled intercostal flap, and the use of steroids in the postoperative period as the key factors for success. If anastomotic complications occur, these can be treated conservatively by laser recanalization and bronchial stenting.
Rendina
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EA
University of Rome, La Sapienza, Department of Thoracic Surgery, Italy.
Venuta
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F
Ciriaco
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Ricci
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C
D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods; D001980:Bronchi / Q000601:surgery*; D002283:Carcinoma, Bronchogenic / Q000401:mortality / Q000601:surgery*; D000075202:Contraindications; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000601:surgery; D011013:Pneumonectomy; D011183:Postoperative Complications / Q000628:therapy; D011651:Pulmonary Artery / Q000601:surgery*; D016896:Treatment Outcome