30. Favorable Results After Sleeve Lobectomy or Bronchoplasty for Non-small Cell Lung Cancer

Hon Chi Suen, Tracey Guthrie, Mary Pohl, Sudhir Sundaresan, Charles L. Roper, Joel D. Dooper, G. Alexander Patterson

Washington University School of Medicine

St. Louis, Mo.

To study the results of sleeve lobectomy or bronchoplasty, we retrospectively reviewed 76 patients who underwent such operations from 1987 to April 1998. Seventy resections were for non-small cell lung cancers which included right upper lobectomy (n=37), right-upper and middle lobectomy (n=37), right middle and right-lower lobectomy (n=4), and resection of brochos intermedius (n=1) or left-main bronchus (n=5). Thirty-day or in-hospital mortality was 1.7 percent (one patient). No bronchopleural fistula occurred post-operatively and anastomic stricture occurred in only one patient (1.7 percent). All patients had complete follow up from one month to 8.6 years (mean 2.3 years) and the three year actuarial survival for Stage one (n=22), two (n=18), and three (n=25) patients were 70 percent, 60 percent and 61percent, respectively. Patients with compromised pre-operative lung function (FEVI < 1.5L, n=11X) had worse three year actuarial survival (27 percent) compared to non-compromised patients (71 percent). In summary, sleeve lobectomy or bronchoplasty for lung cancer can be performed with very low peri-operative mortality and good intermediate term survival. Survival was worse for patients with compromised lung function.