title: Bronchial and bronchovascular sleeve resection for treatment of central lung tumors.
abstract: BACKGROUND
  To improve postoperative pulmonary reserve, we have employed parenchyma-sparing resections for central lung tumors irrespective of pulmonary function. The results of lobectomy, pneumonectomy, and sleeve resection were analyzed retrospectively.
  
  
  METHODS
  From October 1995 to June 1999, 422 typical lung resections were performed for lung cancer. Of these, 301 were lobectomies (group I), 81 were sleeve resections (group II), and 40 were pneumonectomies (group III).
  
  
  RESULTS
  Operative mortality was 2% in group I, 1.2% in group II, and 7.5% in group III (group I and II vs. group III, p<0.03). Mean time of intubation was 1.0+/-4.1 days in group I, 0.9+/-1.3 days in group II, and 3.6+/-11.2 days in group III (groups I and II vs. group III, p<0.01). The incidence of bronchial complications was 1.3% in group I, none in group II, and 7.5% in group III (group I and II vs group III, p<0.001). After 2 years, survival was 64% in group I, 61.9% in group II, and 56.1% in group III (p = NS). Freedom from local disease recurrence was 92.1% in group I, 95.7% in group II, and 90.9% in group III after 2 years (p = NS).
  
  
  CONCLUSIONS
  Sleeve resection is a useful surgical option for the treatment of central lung tumors, thus avoiding pneumonectomy with its associated risks. Morbidity, early mortality, long-term survival, and recurrence of disease after sleeve resection are similar to those seen after lobectomy.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, University Hospitals Homburg, Homburg/Saar, Germany.
authors.forename: H F
authors.initials: HF
authors.lastname: Lausberg
authors.forename: T P
authors.initials: TP
authors.lastname: Graeter
authors.forename: O
authors.initials: O
authors.lastname: Wendler
authors.forename: S
authors.initials: S
authors.lastname: Demertzis
authors.forename: D
authors.initials: D
authors.lastname: Ukena
authors.forename: H J
authors.initials: HJ
authors.lastname: Schäfers
mesh_terms: D000368:Aged; D001980:Bronchi / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009367:Neoplasm Staging; D011013:Pneumonectomy; D012189:Retrospective Studies; D019616:Thoracic Surgical Procedures