title: [Technique, results and impact of induction chemotherapy in sleeve lobectomy for lung cancer].
abstract: OBJECTIVE
  The aim of this study was to evaluate the safety of continuous nonabsorbable (3/0 polypropylene) sutures for sleeve lobectomy, and the influence of induction chemotherapy on postoperative outcome in patients with lung malignancies.
  
  
  METHODS
  A review of a prospective database of a single surgeon identified 41 consecutive patients who underwent sleeve lobectomy from May 1998 to July 2003. Bronchial reconstruction was done placing two 3/0 polypropylene sutures at the far side of the cartilaginous wall and subsequently fixed. Afterwards, two running sutures were performed in order to obtain a telescopic anastomosis.
  
  
  RESULTS
  Twenty-four patients (59%) underwent induction chemotherapy. There were 31 right upper, 3 left lower ''reverse'', and 7 left upper sleeve lobectomies with radical lymph node dissection. Eight patients underwent reconstruction of the pulmonary artery. There were 34 non-small cell lung cancers, 3 limited small cell lung cancers, 1 neuroendocrine large cell carcinoma, and 3 bronchial carcinoid tumors. N2, N1, and N0 diseases were found in 13, 12 and 16 patients, respectively. Post-operative morbidity and mortality were 14.5% (n=6) and 4.8% (n=2) (1 patient, 4%, after induction chemotherapy). The rate of postoperative anastomotic complications was 2.4% (n=1). Late bronchial stenosis developed in 3 cases, but all were successfully medically treated. Twenty-nine patients are still alive, 27 without evidence of disease. The overall 2-year probability of survival (Kaplan-Meier) was 59%. Induction chemotherapy did not influence postoperative morbidity/mortality (chi2 test: P=0.64/P=0.56).
  
  
  CONCLUSIONS
  Continuous nonabsorbable suture for sleeve lobectomy is quick and technical easy to perform, with low postoperative morbidity/mortality; induction chemotherapy does not influence postoperative outcome in these patients.
authors.affiliation: Divisione di Chirurgia Toracica, Istituto Europeo di Oncologia, Milano, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Borri
authors.forename: F
authors.initials: F
authors.lastname: Leo
authors.forename: D
authors.initials: D
authors.lastname: Galetta
authors.forename: G
authors.initials: G
authors.lastname: Veronesi
authors.forename: P
authors.initials: P
authors.lastname: Solli
authors.forename: F
authors.initials: F
authors.lastname: Petrella
authors.forename: R
authors.initials: R
authors.lastname: Gasparri
authors.forename: P
authors.initials: P
authors.lastname: Scanagatta
authors.forename: L
authors.initials: L
authors.lastname: Spaggiari
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001980:Bronchi / Q000601:surgery*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000379:methods*; D011126:Polypropylenes; D011446:Prospective Studies; D012189:Retrospective Studies; D016019:Survival Analysis; D013536:Suture Techniques
chemical_list: D011126:Polypropylenes