Current morbidity, mortality, and survival after bronchoplastic procedures for malignancy

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Pulmonary Medicine

Background:

• Bronchoplastic procedures have seen a nearly fourfold increase in utilization over the past decade.
• These surgical techniques are valuable for benign endobronchial lesions, airway trauma, low-grade malignancies, and select lung cancer cases.
• Malignancy accounts for 89% of all bronchoplastic procedures performed.

Purpose of the Study:

• To evaluate the incidence of complications and survival rates associated with bronchoplastic procedures for carcinoma.
• To compare outcomes between sleeve lobectomy and sleeve pneumonectomy in lung cancer patients.

Main Methods:

• A retrospective review of 1,915 bronchoplastic procedures for carcinoma over a 12-year period.
• Analysis of complication rates, including local recurrence, mortality, pneumonia, atelectasis, stenosis, fistulas, and pulmonary embolism.
• Stratification of results based on procedure type (sleeve lobectomy vs. sleeve pneumonectomy) and cancer stage.

Main Results:

• The most frequent complications were local recurrence (10.3%), 30-day mortality (7.5%), and pneumonia (6.7%).
• Five-year survival rates for stages I, II, and III lung carcinoma were 63%, 37%, and 21%, respectively.
• Sleeve lobectomy demonstrated complication rates comparable to pneumonectomy and similar long-term survival for select lung cancer patients.

Conclusions:

• Bronchoplastic surgery, particularly sleeve lobectomy, offers a viable lung-sparing option for select patients with resectable lung carcinoma.
• These procedures provide acceptable complication rates and long-term survival outcomes compared to conventional resections.
• The increasing use of bronchoplastic techniques highlights their importance in modern thoracic surgical oncology.