Total Lung-sparing Surgery for Tracheobronchial Low-grade Malignancies

Area of Science:

• Thoracic surgery
• Surgical oncology
• Pulmonary medicine

Background:

• Low-grade bronchial tumors often require minimal resection margins for complete disease control.
• Total lung-sparing tracheobronchial sleeve resections represent an advancement in treating these conditions.

Purpose of the Study:

• To evaluate the safety and efficacy of total lung-sparing tracheobronchial sleeve resections.
• To assess outcomes for patients with low-grade tracheobronchial tumors treated with this technique.

Main Methods:

• Retrospective data collection from 98 patients undergoing lung-sparing procedures for low-grade tracheobronchial tumors (1984-2019).
• Analysis included patient demographics, pre-operative treatments, surgical resection sites, histologic classifications, and post-operative outcomes.
• Follow-up data was collected to determine survival rates and recurrence patterns.

Main Results:

• The study included 98 patients (47% female, 53% male) with a median age of 39 years.
• Common tumor types included typical carcinoids (38%), adenoid cystic carcinomas (30%), and mucoepidermoid carcinomas (15%).
• No perioperative mortality was observed, with a median hospital stay of 8 days and 27% experiencing complications. The 5-year survival rate was 97%.

Conclusions:

• Total lung-sparing tracheobronchial sleeve resection is a safe and adequate technique for selected patients with low-grade endobronchial malignant diseases.
• The procedure requires advanced surgical skills and is associated with very low hospital morbidity and mortality.
• Encouraging the use of this technique in experienced centers is recommended.