Optimal timing of surgery for bronchial sleeve resection after neoadjuvant chemoradiotherapy.
J Surg Oncol
; 122(2): 328-335, 2020 Aug.
Article
em En
| MEDLINE
| ID: mdl-32436267
ABSTRACT
INTRODUCTION:
Sleeve resection is an established oncological operative treatment for centrally located tumors with reduced complications compared to pneumonectomy. In cases of neoadjuvant chemoradiotherapy, the optimal timing of surgery for bronchial anastomotic healing has not been adequately explored. MATERIALS ANDMETHODS:
Between 2006 and 2017, 584 tracheobronchial sleeve resections were retrospectively analyzed. We selected all patients (n = 88) after sleeve lobectomy or sleeve bilobectomy for lung cancer with fully completed neoadjuvant chemoradiotherapy. Bronchial healing was assessed by bronchoscopy on the 7th postoperative day using our earlier published classification from grades 1 to 5.RESULTS:
The median interval to surgery was 50 days (interquartile range 46-53, mean 50.03 ± 3.72). Mean anastomotic grade was 2.05 ± 1.03 and in 29.5% of the patients a critical anastomosis (grade ≥3) was documented. Anastomotic healing showed optimal results (bronchoscopic grade mean value 1.5 ± 0.70) between the 6th and 8th postchemoradiotherapy week (P = .001). All patients operated before (bronchoscopic grade mean value 2.3 ± 1.02) or after the above period (bronchoscopic grade mean value 2.5 ± 1.15) had an increased ratio of anastomotic healing complications.CONCLUSION:
It is safer to perform sleeve-resections for non-small cell lung cancer after neoadjuvant trimodal treatment between the 6th and 8th week of completion of chemoradiotherapy.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pneumonectomia
/
Anastomose Cirúrgica
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Carcinoma Pulmonar de Células não Pequenas
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Neoplasias Pulmonares
Limite:
Female
/
Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Surg Oncol
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Alemanha