Impact of pulmonary vein-first ligation during lobectomy on the postoperative survival and recurrence rates in...

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Pulmonary Medicine

Background:

• Surgical manipulation during lung cancer lobectomy can increase circulating tumor cells, raising metastasis risk.
• Optimizing surgical techniques is crucial for improving patient prognosis in lung cancer treatment.

Purpose of the Study:

• To investigate the impact of ligating the tumor-draining pulmonary vein first during lobectomy on lung cancer patient prognosis.
• To determine if a "vein-first" approach improves survival and recurrence rates compared to conventional methods.

Main Methods:

• Retrospective evaluation of patients undergoing curative lobectomy for solitary non-small cell lung carcinoma (2012-2016).
• Patients were divided into a "vein-first" group (pulmonary veins ligated before artery/bronchus) and an "other procedure" group.
• Propensity score matching was used to create comparable patient cohorts for analysis.

Main Results:

• The vein-first group demonstrated significantly better 5-year overall survival (85.6% vs. 69.4%) and recurrence-free survival (73.4% vs. 53.5%).
• The cumulative recurrence rate at 5 years post-surgery was significantly lower in the vein-first group (21.7% vs. 38.3%).
• These improvements were observed after propensity score matching, indicating the technique's efficacy.

Conclusions:

• Ligating the pulmonary vein first during lung cancer lobectomy is associated with improved overall survival and recurrence-free survival.
• This surgical approach may reduce the cumulative recurrence rate in non-small cell lung cancer patients.
• The "vein-first" technique represents a promising strategy for enhancing surgical outcomes in lung cancer treatment.