[Bronchoplastic procedures for the resection of malignant bronchial neoplasms]

Bronchoplastic procedures have become established in the treatment of bronchial malignancies. We report our results on 108 operations performed between 1994 and 2001.

Bronchial reconstruction techniques (wedge resection, end-to-end-anastomosis, y-sleeve), comorbidity (cardiovascular, respiratory, pulmonary, neoadjuvant chemotherapy, alcoholism), postoperative complications (septic/aseptic, light/severe), histology, tnm-stage and postoperative follow up (days) were recorded prospectively.

The bronchial tree was reconstructed with an end to end anastomosis in 75 cases (69.4%), a y-sleeve in 17 (15.7%) and a wedge resection in 16 (14.8%). In 11 patients (10.2%), an additional angioplasty of the pulmonary artery was performed. The comorbidity rate was 89.8%. A total of 52 patients (49.1%) presented with one or more cardiovascular risk factors and 84 patients (77.8%) with one or more respiratory risk factors. The overall postoperative morbidity was 26.8% and the mortality 5.5%. Aseptic complications were observed in 12 cases (11.1%) with a mortality of 25% while septic complications occurred in 17 patients (15.7%) with a mortality of 17%. Anastomotic fistulas occurred in three patients (2.8%) and pneumonia in 11 (10.2%). Stage I was found in 46 patients (42.6%), 29 (26.8%) had stage II, 21 (19.5%) stage IIIA, five (4.6%) stage IIIB and two had stage IV (1.8%). The follow up period ranged from 64 to 2,654 days (mean 756.42+/-643.46, median 575.0). Seven patients (6.5%) died with no evidence of disease. After 2 years, 65% of all patients were alive, after five years this had dropped to 50%.

Bronchoplastic procedures are a safe method for the treatment of bronchial malignancies, even in cases with high comorbidity, and should be performed whenever possible.