TY - JOUR T1 - Lung sparing surgery by means of extended broncho-angioplastic (sleeve) lobectomies JO - Archivos de Bronconeumología T2 - AU - Gómez-Caro,Abel AU - García,Samuel AU - José Jiménez,María AU - Matute,Purificación AU - Gimferrer,J.M. AU - Molins,Laureano SN - 15792129 M3 - 10.1016/S1579-2129(11)70016-7 DO - 10.1016/S1579-2129(11)70016-7 UR - https://www.archbronconeumol.org/en-lung-sparing-surgery-by-means-articulo-S1579212911700167 AB - ObjectiveTo determine the morbidity, mortality and survival of sleeve lobectomy procedures extended to more than one lobe compared with bronchoplasty. Patients and methodsBetween September 2005 and May 2010, a total of 535 patients diagnosed with bronchogenic carcinoma who fulfilled the criteria of clinical, oncological and functional operability were treated in our unit. Central tumors (n=95) that were unresectable using simple lobectomy were scheduled for sleeve lobectomy techniques or, if not possible, pneumonectomy. ResultsA total of 58 (11%) procedures were performed: 46 simple bronchoplastic lobectomies (SBL) and 12 extended sleeve lobectomies (ESL). In the SBL group, there were 32 bronchial (70%), 7 vascular (15%) and 7 bronchovascular (15%) reconstructions. In the ESL group, 8 (66.7%) were bronchial and 4 (33.3%) were bronchovascular reconstructions. The most frequent type of resection was the right upper lobe (RUL)+segment 6 in five (41%) cases, followed by RUL+middle lobe. There were 2 (3%) deaths in the SBL group. Morbidity was 34% in the SBL and 33% in the ESL group (P>0.05). Fifteen patients received neoadjuvant chemoradiotherapy for histologically-confirmed cN2; the number of complications, however, was not significantly higher. No risk factors were detected in any variable studied that would affect ESL compared to the SBL group (P>0.05). The patients in both groups with a higher morbidity were pN1, located in the left upper lobe and associated with vascular reconstruction (P<0.05). The overall five-year survival was 61.6%; SBL (61%) and ESL (68.9%) with no differences between groups (P>0.05). ConclusionsESL are technically more demanding procedures, but they do not increase morbidity or mortality compared to simple bronchoplasty, and have similar survival. ER -