[Surgical treatment of lung cancer for both preserving lung function and maintaining radicality--bronchoplastic...

Fifty cases with lung cancer given bronchoplastic surgery were discussed. Five-year survival rates of all of the cases, those with squamous cell carcinoma, pathological stage I + II cases and absolute curative cases were 36%, 42%, 46% and 59%, respectively, excluding operation death and hospital death. These results were virtually comparable with those of all of the cases with lung cancer which were ever resected in our hospital. The prognosis for cases with adenocarcinoma and of cases operated with bronchoplasty was poor because of direct bronchial invasion from inter-lobar lymph-node metastasis. Hence, this procedure could be better indicated for cases with squamous cell carcinoma, direct primary tumor invasion of the bronchus, and these in which absolute curative operation could be expected clinically. As is characteristic, suture failure occurred in 3 cases, and 2 of them which were followed by pulmonary arterial fistula died of massive bleeding. Preoperative BAI (Bronchial Arterial Infusion had been performed in all 3 cases. It is suggested that there may will be some relation between BAI and suture failure. From the viewpoint of technique, both blood supply preserving and tension relaxing procedures are the most important to avoid suture failure.