Broncho-angioplastic pulmonary resection, pneumonectomy and lobectomy: A comparison study / 第二军医大学学报

ABSTRACT

Objective: To search for the indications of broncho-angioplastic pulmonary resection by comparing it with pnumonectomy and lobectomy in patients with non-small cell lung cancer. Methods: Sixty-four patients with non-small cell lung cancer (TNM classification: T0 21, N1 28 and N2 15) underwent broncho-angioplastic pulmonary resection in our hospital from 1980 to 2000. The experience on the operative method and perioperative managements were summarized and the postoperative mortalities were compared between patients with different TNM classifications. Meanwhile, 64 non-small cell lung cancer patients receiving pneumonectomy and 64 receiving lobectomy during the same period were also included in this study, and their postoperative mortalities and complications were compared with those of broncho-angioplastic pulmonary resection. Results: The 3, 5 and 10-year survival rates of patients receiving broncho-angioplastic pulmonary resection were 58%, 42% and 19%, respectively, with a medium survival time of 45.76 months. The 3, 5 and 10-year survival rates of 21 N0 patients were 82%, 56% and 29%, respectively; of 28 N1 patients were 56%, 39% and 27%, respectively; and of 18 N2 patients were 21%, 12% and 0, respectively. Significant difference was found between each TNM classification group in survival rates (P<0.01). The postoperative mortalities and complications in patients receiving broncho-angioplastic pulmonary resection were similitar with those of pneumonectomy, but significantly higher than those of lobectomy (P<0.01). Conclusion: Broncho-angioplastic pulmonary resection expands the indication spectrum of the lung cancer and improves the post-operation life quality of patients. Broncho-angioplastic pulmonary resection is suitable for patients with lung cancer of N0 or N1 status, but not recommendable for N2 status.