Bronchoplastic and pulmonary arterioplastic procedures in the treatment of bronchogenic carcinoma.
OBJECTIVE
Bronchoplastic and pulmonary arterioplastic procedures have become increasingly popular in recent years as an alternative to pneumonectomy, especially for patients with compromised cardiopulmonary reserve. We reviewed our experience with the procedure to determine the operative technique, indication for the procedure and long-term results.


METHODS
From January 1981 to December 2000, 65 bronchoplasties, four pulmonary arterioplasties and three combined broncho-angioplasties were performed for bronchogenic carcinoma.


RESULTS
Of the 72 patients, 31 had stage I disease, 29 had stage II and 12 had stage III disease. One patient (1.4%) died of bilateral pneumonitis postoperatively. Atelectasis occurred in two patients (2.8%), empyema in one (1.4%), and bronchial fistula in one (1.4%). There were no bronchial stenoses after bronchoplastic procedures, and no vascular complications after angioplastic procedures. The 1-, 3- and 5-year survival rates for the entire group were 86.0%, 47.0% and 29.8%, respectively. The difference in survival was significant between stage I and II disease (p=0.0001) and between stage I and III disease (p<0.0001), but not between stage II and III disease (p=0.0779).


CONCLUSIONS
Bronchoplastic, pulmonary arterioplastic and broncho-angioplastic procedures can be performed safely. Bronchoplastic procedures offer patients with bronchogenic carcinoma a long-term result comparable to that with radical lung resection. Angioplastic and combined broncho-angioplastic procedures should only be used in patients who cannot tolerate pneumonectomy due to poor cardiopulmonary reserve.
Liu
Jun-Feng
JF
Department of Thoracic Surgery, Fourth Hospital, Hebei Medical University, Shijiazhuang, People's Republic of China. liujf@heinfo.net
Wang
Qi-Zhang
QZ
Tian
Zi-Qing
ZQ
Zhang
Yu-De
YD
D001980:Bronchi / Q000601:surgery*; D002283:Carcinoma, Bronchogenic / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000379:methods; D011651:Pulmonary Artery / Q000601:surgery*; D019651:Plastic Surgery Procedures; D015996:Survival Rate