Pulmonary angioplastic procedure for lung cancer surgery

Although bronchoplasty for the treatment of lung cancer is widely accepted as a reliable, safe procedure for the preservation of lung function, there have been only a few reports on pulmonary artery (PA) resection and reconstruction.

Retrospectively, we reviewed our medical records of pulmonary angioplastic procedures and assessed the results.

A total of 25 patients (5 women, 20 men) with a mean age of 68 years (range 44-85 years) underwent a pulmonary angioplastic procedure for lung cancer surgery. Altogether, 13 patients had adenocarcinoma, and 11 had squamous cell carcinoma. The cancers were located in the left lung in 15 cases and in the right lung in 10 cases. The PA reconstructions comprised 4 circumferential resections and anastomoses, 18 wedge resections and end-to-end anastomoses, 2 tangential resections with direct suturing, and 1 wide wedge resection and autologous pericardial patch repair. Six patients underwent concomitant bronchoplasty with pulmonary artery reconstruction. Prior to surgical treatment, seven patients had received neoadjuvant therapy. Although early postoperative complications occurred in eight patients (32%), no operative or in-hospital deaths occurred. All the patients in this series were discharged from hospital and went home. The overall 5-year survival rate was 45%, with a mean 27 months of follow-up.

Most operative complications after PA reconstruction were controllable despite the high morbidity rate. Pulmonary angioplastic procedures for the surgical treatment of lung cancer are both useful and feasible with good intermediate-term results.