[Results and prevention of complications in bronchoplastic surgery in lung cancer]

Fifty-eight patients have undergone bronchoplastic surgery for lung cancer and were reviewed in an attempt to evaluate its postoperative survival rate and to establish a certain method to prevent postoperative complications. Five-year survival rates of the patients with the reconstructive surgery were 36.9, 66.6, 7.9 per cent in over-all patients, stage I and II patients, and stage III patients, respectively. These results can compare favorable with the results obtained in patients who underwent standard operation for lung cancer. Seven of 9 patients with sleeve lobectomy and pulmonary artery reconstruction died within 2 years and 7 months postoperatively, and 4 of them showed distant metastasis. This type of operation may be alternative to pneumonectomy only when pneumonectomy would not be tolerated because of low cardiopulmonary reserve. Six of 8 patients died within 3 years after carina reconstruction. In this type of operation 4 cases showed tumor relapse around anastomotic site. Including 4 patients with carina reconstruction, 8 cases revealed postoperative local tumor recurrence despite the tumor free bronchial stump by frozen sections. These results indicate that prophylactic radiation therapy may be necessary to prevent local tumor relapse after the reconstructive surgery for the advanced lung cancer patients.