TY - JOUR
T1 - Extended sleeve lobectomy after induction chemoradiotherapy for non-small cell lung cancer
AU - Toyooka, Shinichi
AU - Soh, Junichi
AU - Yamamoto, Hiromasa
AU - Yamane, Masaomi
AU - Hattori, Shigeru
AU - Shien, Kazuhiko
AU - Miyoshi, Kentaroh
AU - Sugimoto, Seiichiro
AU - Oto, Takahiro
AU - Miyoshi, Shinichiro
PY - 2015/9/17
Y1 - 2015/9/17
N2 - Purpose: Extended sleeve lobectomy is a challenging surgery. While induction chemoradiotherapy (ChRT) followed by surgery is one of the therapeutic strategies used for locally advanced non-small cell lung cancer (NSCLC), ChRT can impair the anastomotic healing potential. We herein present our experience with cases who underwent an extended sleeve lobectomy after induction ChRT. Methods: The medical records of patients who underwent a surgery for NSCLC after ChRT were reviewed. Results: Between December 2007 and January 2013, nine patients underwent an extended sleeve lobectomy; the left lingular division and lower lobe in four patients, the right upper lobe and trachea in one patient, the carina and trachea in one patient, the right middle and lower lobes in one patient, the right upper and middle lobes and carina in one patient and the right upper lobe and superior segment of the lower lobe in one patient. While no postoperative 90-day deaths occurred, one case developed a bronchopleural fistula on postoperative day (POD) 25 and one case developed a bronchovascular fistula on POD 163. No cases of local recurrence developed. Conclusions: Our experience suggests that an extended sleeve lobectomy after induction ChRT is feasible, but careful patient selection and perioperative management are mandatory.
AB - Purpose: Extended sleeve lobectomy is a challenging surgery. While induction chemoradiotherapy (ChRT) followed by surgery is one of the therapeutic strategies used for locally advanced non-small cell lung cancer (NSCLC), ChRT can impair the anastomotic healing potential. We herein present our experience with cases who underwent an extended sleeve lobectomy after induction ChRT. Methods: The medical records of patients who underwent a surgery for NSCLC after ChRT were reviewed. Results: Between December 2007 and January 2013, nine patients underwent an extended sleeve lobectomy; the left lingular division and lower lobe in four patients, the right upper lobe and trachea in one patient, the carina and trachea in one patient, the right middle and lower lobes in one patient, the right upper and middle lobes and carina in one patient and the right upper lobe and superior segment of the lower lobe in one patient. While no postoperative 90-day deaths occurred, one case developed a bronchopleural fistula on postoperative day (POD) 25 and one case developed a bronchovascular fistula on POD 163. No cases of local recurrence developed. Conclusions: Our experience suggests that an extended sleeve lobectomy after induction ChRT is feasible, but careful patient selection and perioperative management are mandatory.
KW - Chemoradiotherapy
KW - Induction therapy
KW - Lung cancer
KW - Sleeve lobectomy
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U2 - 10.1007/s00595-014-1025-y
DO - 10.1007/s00595-014-1025-y
M3 - Article
C2 - 25212567
AN - SCOPUS:84939203848
VL - 45
SP - 1121
EP - 1126
JO - Japanese Journal of Surgery
JF - Japanese Journal of Surgery
SN - 0941-1291
IS - 9
ER -