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Efficacy and safety of tracheobronchoplasty after induction therapy for locally advanced lung cancer.

OBJECTIVES
Patients receiving induction therapy may have increased risk of morbidity and mortality after surgery. We retrospectively evaluated the influence of preoperative treatment in patients who underwent sleeve resection for lung cancer.


METHODS
A series of 48 consecutive patients who underwent sleeve resection with a telescoping anastomosis was retrospectively analyzed. A sleeve lobectomy and pneumonectomy were performed in 41 and 7 patients, respectively. Twenty patients received preoperative induction therapy; of them, 16 received induction chemoradiotherapy and 4 received only chemotherapy. Twenty-eight patients underwent the procedure without adjuvant therapy.


RESULTS
The telescopic procedure was performed by placing sutures around the proximal and distal portions of the bronchial cartilage without wrapping the anastomosis. Among the 20 patients who received induction therapy, pulmonary angioplasty was performed in 5 and chest wall resection was performed in 3. Seven of these 20 patients (35%) had postoperative complications. Among the 28 patients without preoperative adjuvant therapy, pulmonary angioplasty was performed in 3, diaphragmatic resection was performed in 1, and chest wall resection was performed in 1. Three of these 28 patients (11%) had postoperative complications. Complications relating to the anastomosis occurred in 1 patient (5.0%) who received induction therapy; however, no operative deaths occurred. Bronchoscopic examinations demonstrated that mucosal healing was prolonged in patients who underwent induction therapy.


CONCLUSION
Induction therapy did not significantly affect morbidity or mortality among patients who underwent sleeve resection.