title: Wedge bronchoplastic lobectomy for non-small cell lung cancer as an alternative to sleeve lobectomy.
abstract: OBJECTIVE
  Sleeve lobectomy was introduced for patients with lung cancer whose pulmonary reserve was inadequate for pneumonectomy. However, the safety and survival benefits of wedge bronchoplastic lobectomy as an alternative to sleeve lobectomy have not been thoroughly studied. This study was performed to evaluate the safety and oncologic results of wedge bronchoplastic lobectomy for lung cancer.
  
  
  METHODS
  We retrospectively analyzed 191 patients who underwent wedge bronchoplastic lobectomy and mediastinal lymph node dissection from 2001 to 2009.
  
  
  RESULTS
  There were 174 male patients with a mean age of 61.8 ± 8.2 years. The median follow-up duration was 28 months. Nine patients showed severe postoperative complications: bronchopleural fistulas (n = 3), necrosis at the bronchoplasty site (n = 1), or obstruction (n = 5). The operative mortality rate was 3.7%. Local and regional recurrences were reported in 17 and 12 patients, respectively. The 5-year overall survival was 62.8%. The 5-year overall survival was 68.6% in N0, 64.4% in N1, and 52.6% in N2 (P = .09). The 5-year overall freedoms from local recurrence and locoregional recurrence were 85.3% and 78.9%, respectively, which did not differ by nodal status. A multivariate analysis showed that positive N1 and N2 nodes were risk factors (P = .036 and P = .042, respectively) for overall survival after wedge bronchoplastic lobectomy.
  
  
  CONCLUSIONS
  Wedge bronchoplastic lobectomy for lung cancer is a safe and feasible procedure that does not compromise oncologic principles. It can be considered an appropriate alternative to sleeve lobectomy and pneumonectomy, regardless of nodal status.
authors: Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi, Republic of Korea.
authors: Seong Yong
authors: SY
authors: Park
authors: Hyun-Sung
authors: HS
authors: Lee
authors: Hee-Jin
authors: HJ
authors: Jang
authors: Jungnam
authors: J
authors: Joo
authors: Moon Soo
authors: MS
authors: Kim
authors: Jong Mog
authors: JM
authors: Lee
authors: Jae Ill
authors: JI
authors: Zo
mesh_terms: D000368:Aged; D001999:Bronchoscopy; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D018579:Patient Selection; D011013:Pneumonectomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D011183:Postoperative Complications / Q000209:etiology; D016016:Proportional Hazards Models; D056910:Republic of Korea; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome