title: [Long-term survival after lung-sparing central bronchoplastic procedures [CBPs] for malignant tumors].
abstract: BACKGROUND
  Bronchial malignancies are leading tumour-related cause of death. Prolonged survival can only be expected after radical resections. Central bronchoplastic procedures, which save the whole lung parenchyma, however, may play a role.
  
  
  OBJECTIVE
  These bronchoplastic procedures can be good alternatives for pulmonectomies. The value of these operations can be evaluated by postoperative mortality complication, and the survival rate.
  
  
  METHODS
  In the period of 1985-2012 we operated 7130 bronchial carcinomas. Of these, 7 cases of 80 central broncoplastics we preserved the whole lung (in one case as an alternative for inoperability, in 6 patients as an option instead of pulmonectomy). The indications were carcinoid in four cases, epidermoid carcinoma, mucoepidermoid carcinoma and main carina SCLC after induction chemo-radiotherapy. The average age of the 4 male and of the 3 female patients were 28.5 (14-58) years. In 5 cases the right main bronchus, while in one case the left main bronchus was resected and the bronchial tree was reconstructed. In one case (SCLC patient) we made a complete carina resection and end-to-end anastomosis between the trachea and the rebuilt neocarina to preserve both lungs. The anastomosis was made with 3-4/0 PDS interrupted sutures above a sterile tube (6 cases) and in one case due to a jet catheter which were positioned through the operation field into the distal part of the main healthy bronchus.
  
  
  RESULTS
  There was no operative mortality nor bronchopleural fistula. In the early postoperative period we applied repeated bronchoscopic suctions. In the patient with carina SCLC anastomosis stenosis developed. The main bronchi were temporarily stented. This patient is fit 174 months after the intervention, the Karnofsky index mesures to 90%. Other 5 patients are alive without any consequences of recurrence nor metastasis. The patient with epidermoid carcinoma died 83 months later because of distant metastases of a SCLC, originating from the contralateral lung. The mean survival is 118 (7-233) months.
  
  
  CONCLUSIONS
  In case of some properly selected localised mainstem bronchial malignancies, such as young age and low grade malignancy, radical surgical interventions can be performed with long term survival preserving the whole lung due to special CBPs. Some such successful series and case reports (under 200 cases) can be found in the literature but the long-term survival data was not demonstrated in most publications. In Hungary there has not been any publications yet on such a successful series with long term survival. These results are remarkable within international standards.
authors: Markusovszky Egyetemi Oktatókórház Mellkassebészeti Osztály 9700 Szombathely Markusovszky u. 5.
authors: László István
authors: LI
authors: Kecskés
authors: Markusovszky Egyetemi Oktatókórház Mellkassebészeti Osztály 9700 Szombathely Markusovszky u. 5.
authors: Győző
authors: G
authors: Bátor
authors: Markusovszky Egyetemi Oktatókórház Mellkassebészeti Osztály 9700 Szombathely Markusovszky u. 5.
authors: Arpád
authors: A
authors: Füredi
authors: Markusovszky Egyetemi Oktatókórház Mellkassebészeti Osztály 9700 Szombathely Markusovszky u. 5.
authors: Pál
authors: P
authors: Gehér
authors: Markusovszky Egyetemi Oktatókórház Mellkassebészeti Osztály 9700 Szombathely Markusovszky u. 5.
authors: Béla
authors: B
authors: Kiss
authors: Markusovszky Egyetemi Oktatókórház Mellkassebészeti Osztály 9700 Szombathely Markusovszky u. 5.
authors: Péter
authors: P
authors: Stankovics
mesh_terms: D000293:Adolescent; D000328:Adult; D001980:Bronchi / Q000601:surgery; D002276:Carcinoid Tumor / Q000601:surgery; D002277:Carcinoma / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D018277:Carcinoma, Mucoepidermoid / Q000601:surgery; D018288:Carcinoma, Small Cell / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D005260:Female; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D008175:Lung Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D059351:Organ Sparing Treatments / Q000379:methods*; D011013:Pneumonectomy / Q000379:methods*; D017741:Survivors; D013908:Thoracotomy; D016896:Treatment Outcome
keywords: bronchial malignancy; bronchusrák; central bronchoplastics; centrális hörgőplasztika; hosszú túlélés; parenchyma-saving procedures; survival; tüdőmegtartás