title: Pulmonary artery reconstruction using autologous pericardium or azygos venae substitute for surgical treatment of central non-small cell lung cancer.
abstract: We evaluated the clinico-surgical significance of pulmonary artery (PA) reconstruction using a patch of autologous pericardium/azygos venae substitute to treat central non-small cell lung cancer in 62 patients with pulmonary arteries invaded by tumor. According to TNM-classification, four patients were stage IIb, 46 were stage IIIa, and 12 were stage IIIb. Depending on tumor infiltration, surgical procedures included partial PA tangential resections/reconstructions by a patch of autologous azygos venae, a patch of autologous pericardium and complete PA sleeve resection and reconstruction by a custom-made autologous pericardial conduit interposition. 47 patients received postoperative chemotherapy and 19 received radiotherapy. There were 2 (3.2%) postoperative early deaths due to bronchial anastomotic leakage. Postoperative complications occurred in 17.7% (11/62) patients and all recovered uneventfully. Mean follow-up time after surgical resection was 49.5 (6-12) months and overall ≤1-, 3-, 5-, and ≥10-year survival rates were 80.2, 44.7, 31.4, and 23.1%, respectively. It was concluded that autologous pericardial patch and azygos vein patch reconstruction of PA were safe and effective. Regarding extended circumferential defects after sleeve resection in which end-to-end anastomosis is not feasible, autologous pericardial conduit interposition may be useful for reconstruction when a tumor extensively infiltrates full circumference of the PA.
authors.affiliation: Department of Cardiothoracic Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, 233004, China.
authors.forename: Liu
authors.initials: L
authors.lastname: Xuegang
authors.forename: Shi
authors.initials: S
authors.lastname: Chao
authors.forename: Tang
authors.initials: T
authors.lastname: Zhen
authors.forename: Li
authors.initials: L
authors.lastname: Xiaojun
authors.forename: Liu
authors.initials: L
authors.lastname: Ge
authors.forename: Zhang
authors.initials: Z
authors.lastname: Lei
mesh_terms: D000328:Adult; D000368:Aged; D001401:Azygos Vein / Q000637:transplantation; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010496:Pericardium / Q000637:transplantation; D011013:Pneumonectomy; D011183:Postoperative Complications; D011651:Pulmonary Artery / Q000601:surgery*; D019651:Plastic Surgery Procedures; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D014182:Transplantation, Autologous