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| Reconstruction of the Pulmonary Artery for Lung Cancer: Long Term Results | |
Federico Venuta1, Anna Maria Ciccone2, Marco Anile1, Mohsen Ibrahim2, Francesco Pugliese1, Domenico Massullo2, Tiziano De Giacomo1, Giorgio F. Coloni1, Erino A. Rendina2; 1University Sapienza of Rome - Policlinico Umberto I, Rome, Italy; 2University Sapienza of Rome - Ospedale S. Andrea, Rome, Italy
Methods: Between 1989 and 2008 we performed PA reconstruction in 105 patients (87 men, 18 women; mean age 62 ± 10.5 years) with lung cancer; tangential resections are not included in this series. The mean preoperative FEV1 was 76.1% ± 14%. Twenty-seven patients (25.7%) received induction therapy. We performed 47 sleeve resections (44.8%), 55 (52.3%) reconstructions by a pericardial patch (3 associated with pneumonectomy under cardiopulmonary by pass) and 3 (2.9%) by a pericardial conduit. The surgical technique was uniform throughout the study period. In 65 patients (62%) PA reconstruction was associated with bronchial sleeve resection; in 6 cases also Superior Vena Cava reconstruction was required. Sixteen patients were at stage IB, 36 were stage II, 29 IIIA and 24 IIIB. Sixty-one patients had epidermoid carcinoma and 38 had adenocarcinoma. The mean follow-up was 42.2 ± 40 months. Results: The procedure - related major complications were 1 PA thrombosis requiring completion pneumonectomy and one massive hemoptysis leading to death (28th postoperative day; operative mortality: 1 patient, 0.95%); 28 patients experienced other complications; the most frequent (10 patients) was prolonged air leaks. Overall 5-year survival was 44.3%. Five and ten-year survival for stage I-II and III was respectively 57.1% and 27.1%; and 31.1% and 6.2%. At multivariate analysis induction therapy, stage, histology and patch reconstruction were negative prognostic factors. Conclusion: PA reconstruction is safe and yields excellent long term survival. Our results in a large series of patients support this technique as a viable and effective option for patients with lung cancer. Back to 2009 Annual Meeting Back to Program Outline Back to Main Program |
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