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Arterial Sleeve Lobectomy: Does Pulmonary Artery Reconstruction Type Impact Lung Function?

Aude Nguyen1, Laurence Solovei1, Charles Marty-Ané1,2

  • 1Department of Thoracic and Vascular Surgery, Arnaud de Villeneuve University Hospital, 191 Avenue Doyen Gaston Giraud, 34090 Montpellier, France.

Cancers
|October 28, 2023
PubMed
Summary

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Arterial reconstruction during lung cancer lobectomy maintains lung perfusion and respiratory function, regardless of the specific technique used. This parenchymal-sparing approach demonstrates its validity in preserving lung function post-surgery.

Area of Science:

  • Thoracic Surgery
  • Surgical Oncology
  • Pulmonary Medicine

Background:

  • Lung cancer lobectomy often requires pulmonary artery (PA) reconstruction.
  • The impact of various arterial reconstruction techniques on lung perfusion and function remains an area of investigation.

Purpose of the Study:

  • To evaluate the effect of different arterial reconstruction techniques on lung perfusion following lobectomy for lung cancer.
  • To assess the functional validity and outcomes of arterial sleeve lobectomy.

Main Methods:

  • Retrospective cohort study of 81 patients undergoing lobectomy with PA reconstruction (2001-2020).
  • Comparative analysis of preoperative and postoperative pulmonary function (FEV1) in 48 patients.
  • Analysis of preoperative and postoperative lung perfusion using Technetium-99m scintigraphy in 28 patients, stratified by reconstruction technique.
Keywords:
lung functionlung perfusionnon-small-cell lung cancerpulmonary arterysleeve lobectomy

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Main Results:

  • No significant difference in lung perfusion was observed between preoperative and postoperative states, irrespective of the PA reconstruction method (p=0.47).
  • Postoperative predicted FEV1 significantly underestimated actual measured FEV1 by approximately 11.4%.
  • High patency rate (96%) and a 5-year overall survival of 49% were reported.

Conclusions:

  • Lobectomy with pulmonary artery reconstruction is a functionally valid parenchymal-sparing technique.
  • The specific technique of arterial reconstruction does not significantly impact lung perfusion or overall respiratory function.