Objective : The purpose of this study was to analyse the local recurrence rate and long term survival after sleeve lobectomy for bronchogenic carcinoma.
Methods : From 1985 to 1999, 77 patients underwent sleeve lobectomy for bronchogenic carcinoma of the lung. There were 58 procedures on the right side and 19 procedures on the left. 68 patients had squamous cell carcinoma (88,3%), and 9 had adenocarcinoma (11,7%). Other histological types of malignancy were excluded. The mean follow-up was 52 months and the maximum follow-up time was 180 months.
Results : There were 3 operative deaths (3,9%). Completion pneumonectomy was required in 5 patients because of anastomotic dehiscence in the early postoperative period, a positive resection margin, a benign stenosis at the anastomosic site 5 months postoperative, a destroyed lung 8 months postoperative and an ipsilateral second primary 5 years postoperatively. A total of 23 patients developed major complications (29,8%). Analyses of survival showed a 5-year survival of 45,6% and a 10-year survival of 21,4% for the whole group. Local tumor recurrence in the ipsilateral hemithorax or mediastinum occured in 13 patients (16,8%). Tumor related mortality was 47% (24/51). Seventeen patients died of metastatic disease, 7 patients died of local recurrence without evidence of metastatic disease, two patients died of an extra-pulmonary cause but had metastatic disease the moment they died.
Conclusion : In our opinion sleeve lobectomy is a safe procedure and when technically feasible can be considered the procedure of choice for centrally located bronchogenic carcinoma.