Sleeve resections for squamous cell carcinoma of the lung.
BACKGROUND
Sleeve resection is an advanced technique that was developed as an alternative to pneumonectomy. This study evaluated our cases of sleeve resection for squamous cell carcinoma of the lung and compared the outcomes with the literature reports.


METHODS
In total, 26 bronchial, 5 bronchovascular, and 3 vascular sleeve lobectomies were performed between January 2000 and July 2005 in our clinic. Age, gender, operations, postoperative diagnosis and staging, and postoperative morbidity and mortality were evaluated.


RESULTS
Sleeve resections were performed in 34 patients. All patients were male, with a mean age of 59.4 years. The operations consisted of 16 right upper, 14 left upper, and 1 left lower sleeve lobectomies and 3 superior sleeve bilobectomies. The most common postoperative pathological staging group was stage IIb (32.3%). Operative mortality was 5.9% (n=2). Postoperative morbidity was 20.5% (n=7), including 4 prolonged air leaks plus empyema, 1 prolonged air leak, 1 postoperative bleeding needing revision, and 1 severe bronchostenosis; of these, 6 had persistent atelectasis. The local tumour recurrence rate was 11.7% (n=4). The median survival time and 5-year survival were 36 months and 42%, respectively.


CONCLUSIONS
Sleeve resection proved to be good therapy for lung cancer and has a lower morbidity and mortality than standard pneumonectomies and results in better lung function and quality of life. The anastomosis-related complications are experience-related technical complications and training thoracic surgeons to perform SRs at experienced centres will reduce the morbidity associated with SRs.
Gezer
Suat
S
Faculty of Medicine, Clinic of Thoracic Surgery, Düzce University, Düzce, Turkey. suatdr@hotmail.com
Oz
Gürhan
G
Findik
Göktürk
G
Türüt
Hasan
H
Altinok
Tamer
T
Sirmali
Mehmet
M
Gülhan
Erkmen
E
Ağaçkiran
Yetkin
Y
Kaya
Sadi
S
Taştepe
Irfan
I
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D001980:Bronchi / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011013:Pneumonectomy / Q000379:methods*; D011183:Postoperative Complications / Q000401:mortality; D016019:Survival Analysis; D016896:Treatment Outcome