Background & objective: Bronchial sleeve resection and/or pulmovascular sleeve resection can maximize preservation of normal lung tissues after tumor resection, which provides a resection mode for lung cancer surgery. This study was to investigate the technique, operative results and survival of lung cancer patients after sleeve resection.
Methods: Eighty-two central lung cancer patients underwent sleeve resection in Zhejiang Cancer Hospital from Jun. 2001 to Dec. 2006. Among them, 23 underwent concomitant pulmovascular sleeve resection, 2 underwent pulmovascular sleeve resection alone. All patients received systematic lymph node dissection. The results of lymph node dissection and the occurrence of postoperative complications were studied. The survival of patients was analyzed by Kaplan-Meier method.
Results: An average of 20 lymph nodes (range, 9-57; median, 19 ) were dissected from 82 patients. Of the 82 patients, 49 (59.8%) were at stage N1, 21 (25.6%) at stage N2. Two (2.4%) patients died 2 and 3 days after operation. No bronchial anastomotic leakage occurred. The 1-, 2-, 3-, and 5-year survival rates were 78.4%, 52.5%, 39.1%, and 23.4%, respectively, with a median survival of 26 months. There were no significant differences in 1-, 3-, and 5-year survival rates between male and female patients, or between the patients aged of <60 and > or =60. The differences in 1-, 3-, and 5-year survival rates among N1(-) N2(-), N1 (+) N2(-), N2(+) patients, and among stageI, II, IIIA, IIIB patients were significant (P<0.01).
Conclusions: Perioperative mortality and the incidence of anastomosis-related complications for lung cancer patients after sleeve resection are low. Sleeve resection is an alternative to pneumonectomy for certain indications. Systematic lymph node dissection does not increase operative complications and mortality. The survival of lung cancer patients after sleeve resection is conelated to lymph node metastasis and clinical stage, but has no correlation to gender or age.